HomeMy WebLinkAbout2296 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA-
This is my declaration of ~omiciie and Citizenship in the State of F~orida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
New York
I was formerly a legal resident of ~'rBCuae _ _ _ _ _ _ "
~C;ty~ (State) ~
i
~
~
428 Church Street t
and i ~esided at _ _ However 1 have changed my domiCule t
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since NQVemher 12, 19T1 _ day of
19_____ , and I reside at __1504 N. 39th Street
- - - - - - -
(Street and Number)
FORT PIERCE, SAINt LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual 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 ~
at former domicile, remova! of family to new domicile, purchase of home, etc.)
homestead
~
~ROC~f
R P~~ ~ S
CIERK CtRCWi~~',p~~ t~j ;
RECORD YERiFlEO~,.~
;
~t 1~ SO ~'7j ~
~ ;
~
~ ~
~ -
3
i
~
i
~ '
r ~
H
3 t
~
~ ~
~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~
~
~ ~
I FURTHER CERTIFY that I have no intention fo return to my former domi~ile, and I infend to remain in FOR7
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ,
~
- . ~
, , i~:1i,, l
~ , ' ~ ; ame)
~ ~ Alonzo A. Itiley
.
- ~
_ . ;
~ - - ~ -
_ ' (Address)
_ ~ ' ~
Swa~ taan~'iubscribed before me this 24 day of __~arch , ~q 72 _ -
f=-
: ROGER POITRAS
= CLERK CIRCUIT COURT ~ Notary Public ~
_ ;
~'::u~ gy c c D.C. My Commission expires ~
`,r _
i
f
~
(To be executed in duplicate and originsl filed with Clerk Circuit Court, snd dupliwte with Tsx Assessor.) ~
~ ~oa~200 ~~2~ '
-
13 4