HomeMy WebLinkAbout0467 _ ~ci~ration o~ Domicile a~l Citiz+~n~hip ~ .
"I'O TH~: STATk AI~D COUNTY TAX ASSESSOR,
St. Lucie COUNTY, FLORIDA:
"Ilii~ is my drrlaratiun of Domicile and Citizenship in the Stace af Florida that 1 am filing this day in
~ccordanre, and in cantorn~ity with Section 222,17, Florida Statutes. ~
1 was formerly a legal nsident of Ba-lnmore Maryland , and I
(city) (sute)
n;sided ~l _~$~~~~t-'Cpl,jl~Q j1~1Y1-~- . HOWCVer, [ have changed my domicile to
(Strert andNumber)
and am and havc bri:n a bo?ia fide resident of the State of ~lorida since _ 1st day ot
Januar~,____~._4_ , 19?3 ~ and 1 mside at _ 1004 Penna. Ave. ,
(Strcet and Number)
__For~ Pierce _ , St. Lucie County, Florida,
(city)
and this staternent is to be takc~n as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inseri Aerr any {+ettinrnt Facts, such as sale ot ptoperty or busiorss, or relinquishment of employment at fotmrr
domieile, ?emoral uf family to new domicile, purchast of home, ete.)
My parents own the houses on 3431 S. Indiana River Drive and 1004 Penna. Ave.
together we o~vn the apartment on 101? Chipola Road. M~ parents will retire in
two years to 1004 Penna. Ave. and I intend to also live in Fort Pierce. I am
presently a dentist in the US Army on ac~ive duty stationed at White Sands Missile
Range, New Mexico,
\
fIlEO l?HC ~ECORDEO vA
SLttlCiE C01lNTY FlA-
ROGf ~ s'ut7RAS ~
CLEpK C:~' ~~IT COUR7 ~
RFC(tRn ~ ~ !f P
fFe 10 10 s5 AN'73
~;~5~~4
1 FURTNER CERTlFY that 1 wi!! register at my local address when tht registration books reopen, and
comply with a!1 oiher requirements of a legal resident of this State.
I FURTHER CERTIFY that I have r:o intention to refurn to my former domicile, and I intend to remain in
FQrt Pierce , St. Lucie - , , County;
Florida. permanently_ "r~
_ r/~ /J~~.s -
. (Name)
_ : '`l~ GRIFFITH B. JONES, DDS
C~ -322 Watervliet Ave. , -
~ ~ . S 1'~r~+t~~r (Addrrss)
._~::•-.~,,~~,;;~-;,.F~, ~ White Sands Missile Range, NM 88002
~ ~ ~ 'bed"before me this ~ _ day of (temporary add: ess)
~ . ~ 3
:-J;»~ _
'..i~'_,y=~.~- _ ` .D. 19~
i _ < -
~~~';e r-~,• ~
J~. : :--'it~_ 't~ iiYblie Su - ` e
~'UI i1~~ i-~.~. ' . ~ .
~ty'ecfmtt~isslon expires____ _
(To f~e execuicaf in dupl~catt and u?i~inal f~led w~itb Clerk Citcuit ~ourt, and duplicate with Tax Assesxot) .
i~~~ M6E ~ , , , ~ . , .
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