HomeMy WebLinkAbout2233 Declaration of Domicile anci Citizensh~'~269
TO THE STATE AND COUNTY TAX ASSESSOR,
_~St. Lucie COUNTY, FLORIDA:
This is my dc~claration of Domicile and Citizenship in the State of Florida that 1 am filing this day in ~
accordanc~, and in conformity with Section 222.17, Florida Statutes. ~
1 was formerly a legal resident of Se~~eet8dy ~ NeR York and 1 ~
(citr) (stale) ~
resided at _ 1187 GBrne~ A~r$ . However, I have changed my domicile to ;
(Strret and Numbc7)
and am and have been a bona fide resident of' the State of Florida since lst o-
day of
Feb , 19_~ ~nd 1 reside at 118 Airose Blvd Port St. ~,~Cie
Street and Numbet)
Ft. Pierce ~t. I,uc e
County, Florida,
(c;tr)
and this statement is to be taken as my declaration of citizenship, actua! legal residence and domicile in the State
of Florida.
(lnseri here any pertinent fscts, such ss sale ot property or business, or relinquishment ot employmeet at tormer
domicile, remoral uf family to new domicile, purchase of home, etc.)
Establishing residence
z4~zss
ST
IUCiE COUNTY F~A.
ROCE~ SOIiRAS
CLERK CI~c~U~T COURT
REGQ^n~ YEnf =tEDo~~
~e 6 tQ.s3 AH'T3
~ -
~
I FURTHER CERTIFY that i will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this $tate. ~
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
~'t. Pierce _ ` _ St.Lucie County,
Florida, permanently. '
_ ~ -
<; v r C`~',~•~~'- ,r• ~ ~ -
~'i ~ r•' • ~ I - (Name)
J. ynch
. - 1 G c~ : - - - -
y : e ~ (Address)
r ~~UC '
.
r~~rcO.rn„to ~rt+~'~vtibsctibed bef~re me this 6__ day of
. :
~ t~~a~0 ~ .
~'ebruar ~ ~
- " - y A.D. 19 _ 73_.
~
~_-c~-c~ a-'. ~e~i f
Notary PubGc State of Florida at Larqc ~
My Commission expires~TBn~..Ar~ _1~~~97fi__-
(To be ecrcuted i~ duplicatr and uri~inal filed with Clerk Circuit Court, and duplicate with Tax Assessor)
a oK210 ~cE22~~ - _ _ _
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