HomeMy WebLinkAbout2208 :~.~~~r~ ~
t~eclaratl~n at Dorricile ~nd ~itisenship . . ~ ~
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TQ TN~ S7AT~ AND COUNTY TAX ASSESSOR, 3
ST. IUCIE COUNTY, FIORiDA: • .
This is my declaration of Domicile and Citixanship in tha State of Fiorlda that i am filing thfs day in accordante and
in conformlty with Chaptar 222, Section 222.17, Fiorida Sfatutes.
i was fo~meriy a legei resident of xndfanapol~.s ~ IndiBna
_ (Ciry> ~ (Stats)
and i ~e:ided at _ 82~ North Delsxare ~ , Howover i have changed my damt~ile
• (Straet ~nd Numbe~)
b and •m and have been a bona fide residant af ihe State of Florida since ~2Q~eh day of
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_ December , ~9 and t reside at 22 ~trada AvenuA~ Port St Luoie
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~ ~ FOitT ~IERCE, SAlNT LUCIE COUNTY, FLORIDA . •
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~ and this statament is to ba taken aa my deciarotion of cittzenshtp, actuat legaf residerxe and domfdle in the Stata of Florida.
~ (insert here any pertinent fads, such aa aale of property or buslnes:, or rolinqutshmant of employment
~ ~ at former damicile, removai of famity to new domicile, purchase of homa, etcJ
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' ~ HO~EAD fi~t~PTIOI~ ~ ~
~ : ~ 13~.`7'75 . .
~ `l.-===~~_~ f ~ D ~i h'Q ftEC RDED
~ ,f~ ~ ~~icial R~co~ . ;Q OK _ i • i.!,~ ~ ~ .
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~ ~ - ROGER P01~'Ft,iS, ClL~~t : ~~~pj
ST. LUCI~ COU~~Tr, FLORfDA i~~!~M,~+`~
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1 FURTHER CERTIfY that i wti! compty with atl oth~r requiremant: of e tega! rasidant ~f fF~t~ Stats. .
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- 1 FURTHER CERTIFY tfiat I have no intention ta return ta my former domic~ita, and I inte~nd ta remain In FORT
~ PIERCE, SAtNT LUGtE COUNTY, FLORlDA, permanentty.. ~
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. (Name) Johu H. i~le~dner
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`'i . . 221~ -En~rada Ave., lt.St. Luaie} Ft. Pierce,
y.6 ~~.`OG (Addrssa) Fla.
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•+r .2,Sri!Qrn t ?i
i;:+rbscribed beforu me th)s 22 + d~y of December 19
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} l~~~CUlT COURT Natory Rubik ~
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8y D.C. My Cortuniuion oxpires
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, Cro b~ ~x~vt~d in dvpikal~ ~nd ai~1~ filsd wh~ _ CI~ Ckc~it to~r~t, ~nd ~ whh Tax As~Mra
~ Bp~K sos p~~~o~
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