HomeMy WebLinkAbout0811 . Declaration ot Domicil~e and. Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR. 242103
51. IUCIE COUNTY, FIORiDA:
This ~s my dectaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
:n conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of _ WE'. S t Hart f ord Conn
- - -(City) (State)
S@ldetl br].Ve . However 1 have chan ed m domiGle
and ! resided at _ - - 9 Y
(Street and Numbe~)
ro and am and have been a bona fide resident of the State of Florida since 17~ - - day of
July ~q__ a~d i reside ar Holiday_ Out at S~ . Lucie
~ (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 ihe State of Florida.
.(Insert here any pertinent facts, such as sale of property or business, or reiinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Establishing residence
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CLEP,~C i1~;CUtT C011RT ~
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MNI I~ 1I S? AH '11 ~
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242103
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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 dom~~ile, and I intend to remain in FORT :
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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~ ( a e) . David J. arthy ;
~ _ P.O.Box 83 Jensen Bc, Fla. ;
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1: -'Syvo~n to ag~~u6scribed before me this - L,Srh day of -~Lw_EmbEr_ , 19-7.2
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`~••ROOtR~~crw~a~5 i
~ ' ~ '~a1T COURT Notary Public ~
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~ By ~ _ ~ O.C. My Commission expires ~
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(To be executed in dvplicste and original ~iled with Clerlc Circuit Court, snd duplicate with Tax Assessor.)
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