HomeMy WebLinkAbout5317 ~eclaration of Domicile and Citizenship
245192
T~ THt: ST.1Tt: ~~t~ COL:~TY T:!`C ASS`~:SSOR,
St. I.ucie ~~OUNTY, FLORIDA:
Ti~is is m~~ d<rlaratiun c~f~ Domicilc and Citizcnship in the St;tte of Ftorid:~ ihat l am filing this day in
scrordanc~, an~l in conformiiy with Seciion ~_".17, Florida Statutes.
I was formerly a Icgal rrsidc:nt of _~aY~Chaster COnri ~ and t
(CitY) (State) '
resided at 84___Bucklsnd Street_ . However, I h:~ve changed my domicile to ~
(Street anJ Numbrr)
:~nd am and h.ive becn a bona fide resident of the St~te of Florida since day of
_-_-_~aY.---- 19_ an~! I rc•side at 3~84__ Roselaw~ Blvd White Cit~______
(Street and Number)
Ft. Fierce S~, Lucie County, Florida,
(Ci~y )
and this statcment is to be tak~~n as my dcclaration of citizenship, act~~al legal residence and domicile in the State
oti Florida.
(Insrra here any prrlinent facts, such as salr ot property or busineu, ix relinyuishmrnt of rmployment at former
domicile, removal of family to new domkile, purchase of home, etcJ
t
Eatablis'~ing resider.ce anc: applying f.~r hor~.estead ~
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245192 S
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ST WC1E COUNTY F~A.
ROCER PplTqAS
C~ERII CtZCUiT COURT
RECOFO VERlFIEp..~,,,,,,,~~
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i FURTHER CER1'1FY th;~t 1 K~ill regisier aI my local address when the registration books reopen, and =
c-omply with al! other requirements ut~ a legal resident of this State. `
1 FURTHER CERTI~=Y that I hare no intrntion to r~turn to my former domicile, and 1 intend to remain in j
;
~'t,_ Pierce - - - - , --St_~_~Lt~i_~ - ~'ounty.
~vtUc,i~.p~rmanently ~c~~.~
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Swi~rn ~u''and subscribed beforr m~ this ~1ay ot~
JanuarY_ . a. D. i _ _ .
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Notary Nublic State uf I lunda at Larer
My Commission expires Jar_u=~ry 15 . 1976 '
(Tu be r~rcuted in du~~6.rtr anJ uri~:inel ('r1eJ atth ('lerk CirtuF! l'uurt. and dupli~ate ~+itA T~x ~ssc~,wr)
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