HomeMy WebLinkAbout2750 1
Deciaratio~ ot Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
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This is my decla~atio~ of Domicile and Citizenship in the State of Florida that I am fi~ing this day in actordance and i
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of -
~C~~y) (State)
and 1 resided at _~a!' S _ However I have changed my domicile
(St eet and Number)
to a~d am and have been a bona fide resident of the State of Florida since _ f_' J
71 day of
3 a 7 /1~ ~
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- - - - 19---, and 1 ~eside at -
~ (Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, fLORIDA `
and this statement is to be taken as my declaration of citizenship, actuat legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as saie 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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2265~2
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; c~ER~ c~~cu~t ~ouRr
, RECORO YER~FIEO.,.,~~
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domiule, and 1 intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ksi~/. ~ ...fG~
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s:. • • - (Name)
~ J Ja~aes B. Brannock
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~ . ~ (Address)
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js . . . _ 4, ` .
'-~y SwOth.to and subscribed before me this 30 day of l~arch , ~q 7?
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- ROQER POITRAS
CIRCUIT COURT Notary Public
By G~'~G D.C. My Commission expires
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: (To bs execurod in dupliute and ori~inal fil~d wit1~ Cl~rk Grcuit Courf, and duplipts with Tsx Ass~swr.) ~
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