HomeMy WebLinkAbout2614 DeClaration ot DomiCile and Citize~ship ~2~ :
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~ TO THE STATE AND COUNTY TAX ASSESSOR, ;
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51. LUCIE COUNTY, FIORIDA: ~
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accorda~ce and €
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in conformity with Chapte~ 222, Section 222.17, Florida Statutes. ;
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I was formerly a legal residenf of _Si4~.l1a~211~__ , - _ - ~'sB.Or$~8 i
(C~ty) (State)
and I resided at _ ____54~.4 _1~~.gS~~7@~__ _ _ However I have changed my domic.ile
(Street and Number)
ro and am and have been a bona fide resic~ent of the State of Florida since _ 20th day of
i
auly - . - ~9---?~ and I reside at ----3~~-,IohnsQn ~treet :
(Street and Number) t
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and lhis 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, o~ relinquishment of employment '
at former domicile, removal of family to new domicile, purchase of home, etcJ
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Eatab118hina~ residence ~W~G~D~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this St~~te.
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~ I FURTHER CERTlFY ihat I have no intention to return to my former domiCi(e, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~ . - ~ . X /--~'~lli-?-J .
Y ' - - (Name)
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~ Donald E. Barron
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~ Sworn to and subscribed before me this 29th day of l~arch ~~q 72.
:r
':4 ROGER POITRAS
~ CIRCUIT COURT Notary Public ~
6y D.C. My Commission expires
(To be ~xecu»d in duplicate and ori~inal ~il~d with Cierk Grcuit Cou~f, snd dupliuts with Tax Ass6ssor.)
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