HomeMy WebLinkAbout1789 Declaratio~ ot ~omiClle and Citizenship ,
TO THE STATE AND COUNTY TAX ASSESSOR, 225816 .
Sl. IUCIE COUNTY, FIORIDA:
This is my declaratio~ of Domicile and Citizenship i~ the State of Florida that I am filing this day in attordance and
in tonformity with Chapte~ 222, Settion 222.17, Flo~ide Statutes.
I was formerl a 1 al resident of ~c~C,u
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(City) (Stat ~
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and 1 resided at ~ _ ' However 1 have changed my domicjle ~
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(Street and Number) i
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to and am and have been a bona fide resident of the State of Florida since day ot
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- - - . 19~ and 1 eside at - . -
' (Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, FLOWDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
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(I~sert 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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~ ~ ~2e~.~.~f,Z.r.e~ 225816
fJlE0 ~NO RECORQt~ ~
~T. LUCIE COUNTY F~A. €
~ ROCE~ P~iTRAS
CLERK CI~CUIT COUIIT ;
RECORD VE.°.IFIEO.~..~.~
MINt 1Q 10 zs AH'~Z
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~ 1 FURTHER CERTtFY that 1 will aomply with all other requirements of a leyal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to rernain in FORT
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~ PIERCE, SAII~T~t,,tJ~,iE_-COUNTY, FLORIDA, pe?manently.
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Swor~1 to and subscribed before me this day of , 19~.
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= R ER POITitAS
URCVlT OWtT Notary Public
ci-c~.t~ (p ~c-~.l~
_ ~y D.C. My Commission expires
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~ tTo b~ ~xecuhd in dupliut~ and ori~inal fil~d witb Cl~rk Grcuit Court, and duplicats with Tax Assessor.)
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rlo. 13 _R soox 2~~ PacE17$~
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