HomeMy WebLinkAbout0598 Declaration ot Domicile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR. 2~499~?
51. lUC1E COUNTY, FIORIDA:
This is my declaration of ~omicile and Citize~ship in the State of Florida that I am filing this day in accordance and ~
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of ~!L_~_~P~!_____ ~ -
(City) (State)
and 1 resided at 1 _ ~
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~!__f~ ~v~ • _ _ _ _ _ _ . However I have changed my domicjle ~
(Street and Number) '
to and am and have been a bona fide resident of the State of Florida since .!Q~? _~~1 ~1 ~ _ day of ~
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- - - - - - 19-- and 1 reside at _~d O~ ~ • 3 ~ C~• - - -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this stateme~t is to be taken as my cleclaration of citizenship, adual fega) residence and domicile in ihe State of Florida.
(Inse~t here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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~ 1 FURTHER CERTIFY that I will comply with all othe~ requirements of a leye) resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domi4le, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permaneMly.
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~ (Name)
• ~ ~ ~fRS . HELEN J . ~'AGAN
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_ S rn to and tubstribed before me this ?th day of ~erch ~ 19 72
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:~O~~R ~fIt~AS '
r • CIIt~UtT COURT Notary Public ~
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3 By , ~.C. My Commission expires
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~ (To b~ ~xacut~d in duplicab and ori~inal fil~d with Clsrlc Ci?arit Court, and dupliut~ with Tax Ass~ssor.)
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No. 13 A
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