HomeMy WebLinkAbout2411 Deder~tion ~ o~ Dornicile and Citi~nsl~ip
TO THE STATE ANU COUNTY TAX ASSESSOIt, ~~ri~3OO
_ _ 3T. _I,UCIB, i_ COUNTY. FLORIDA:
i
This is my drelar~tiun of Damicile and Citizenship in the State of Fiorida that I am filing this day in S
accordance. and in conformity with Seciion 222. ! 7, Florida Statutrs.
! was formerly a legal resident of ~PE1'~ _ end 1
lcily) tStale)
rc,~sided at _ 316 Zor1nK A~e. . However. 1 have changed my domicile to '
(Streel and Number)
and am and have been a bona Gde n~sident ot the State of Fiorida since 28th clay ot'
_~Fril , 19_ 72 and 1 reside at _-Rt. 4 HOZ 54 ~
(Sueet aad Numbet)
~'ort Pierce . 4 St. I,ueie County, Florida,
(Citr)
and this statement is to be taken as my deciaration of citizenship, actual legal residence and domicile in the State ;
of Florida. " ~
(Insen here any pertinent fscts, such as sak of property a business; or relinqui~hmmt of emplorment st famer ~
domicile. remora! ot lsmily to new domicik, purchax of home, etc.) ~
To e~tabli~h legel residenee in l~ort Pierce, St. Zucie Count~,
~'lorida.
=T~IICtE COU~ ~
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I FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and t intend to remain in
l~ort Pierae ___TA~ _ 5t. Luci e County,
Florida, permanenUy. -I-~~_1~CltifiZ~LC~~
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t~~,U iT Q ~~i,,~ AL E'D 3AYIl~E~LI " - - -
~ • 'v O - (Nsme)
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• ~sV G
~s r Itoute 4, Doa 54, ~'t. Pieree, ~'le.
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- a~~ , ~~aa«.~~ 33450
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Sworn~l~jnd,s ~#~efore me this , 28th ~~y of
~ ~ , - - ;
•r•~1? ,
. -
A t- ~ ' ~ - A. D. 19_~?
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ROaER TRA3, Clerk Clrauit Co
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BY D. C .
fTo be ssecuted ~n duplxsie aod on~tinsl f~lrA with C{erk CitcuM Cuutl. ~nd auplic~ts vnlh Tu A+rewwl
~ ~ao ~01 ~240~ .
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