HomeMy WebLinkAbout2829 DeCiaration ot Domicile and Citise~ship
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TO THE STATE AND COUNTY TAX ASSESSOR, _ ~
Sl. IUCIE COUNTY, FLORIDA-
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This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of . _ ~/°Sf/EL p _ _ . - _ - _ l_~ss._c--- - '
~C~~,~ (State)
and 1 resided at _ a ~?~_vE____ ST . However I havechanged my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~A ~ day of
19
r~ , and 1 reside at C~~N~ S~°AN~s'N ~c AiYES
(Street and Nu r)
~ ~eX Y / ~ 2-
PORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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 properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
E~tablishin.; reaidency in the County ot
St. Zucie, State of ~lorida •
f'LEO ANO RECORDEO
~T LdCtE COUMIY fLA-
AOCER ?OITRAS
CIERK CIRCUIT COUBt t
I~ECORa vER'FSED~
~ 3 10 Si ~M'ZZ
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~ 226554
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~ I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHfR CERTIFY that I have no intention to return to my former domiCile, and ! intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORFDA, permanently_
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~ <s`r''~'. ~ n -(Na e)
~ James A. ~oodpaater
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. (Address)
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~ I , . - , 3 April 72
'••~5viiom to and subscribed before me this _ day of . 19
~y~; ROGER POITRAS
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CLERK CIRCUIT COURT Notary Public
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gy • rn~ yl _ D.C_ My Commission expires
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(To be executed in dupliute and original filed witl~ Cl~rk Ci?cuit Court, and duplicate with Tax Assessor.)
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13 b001c~.lJV P116E~8~ F
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