HomeMy WebLinkAbout1688 Declaration ot Dor»icile a~d Citizenship ~
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TO THE STATE AND ~OUNTY TAX ASSESSOR, . 2~~'46
51. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in acco~dance and
~
in conformity with Chapter 222, Section 222.17, Florida Statutes. !
I was formerly a legal resident of
(City) (State)
. '
and I resided at E ~ However 1 have changed my domicjle
(St~eet a Number)
to and am and have been a bona fide resident of the State of Florida since day of
, 19..2~, and 1 reside at s~_~.Q~ ~.r./~EE ~?F
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, fIORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment i
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
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ROCER pp~J~
RE~ORO y CIRCUIt ~pyRT
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1 FURTHER CERTIFY that I will comply with all other requirements of a leyal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my former domiCule, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~
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~ (Name)
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` ' ~ r, - (Address)
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~ SMrora, t8,~ibed before me this ~ day of , i 9~?~
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'"t ~~•t.~.~,i~•~~~'S~.
~ Rocde romws
- CLERK CIRCUIT COURT Notary Public
By D.C. My Commission expires
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- (To b~ ex~cut~d in duplicst~ and ori~inal fil~d with Clak Grwit Cour~, and dupliut~ with Tax Ass~ssor.)
BGRK~OO PAGEIUB~T
No. 13
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