HomeMy WebLinkAbout0294 Deaciaration ot ~omicil~ anc~ ~it3Y~n~ttip "D
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domitile and Citizenship in the State of Florida that I am filing this day in accordante and
in conformity with i.hapter 222, Section 222.17, Florida Statutes.
Decatu~ I1linoia
I was formerly a legal resident of
- -
(City) (State)
201~0 ~1. ~+S11i~
and I resided at _ - - - - _ _ . However I have changed my domiCile
(Street and Number) .
to and am and have been a bona fide resident of ihe State of Florida since day of
~ A pril 6~r 1S5 W. Prima Vista Blvd~ Port St.
19----, and I reside at - I.ltcli~_
(St~eet and Number)
FORT PIERC@, SAINT LUCIE COUNTY, PLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal res~dencE and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property o~ business, or relinquishment of employment
at former domicile, removal of family to new domicile, pur=hase of home, etc.)
~stablishing residenee
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FILED AND RECp - p~p
- . . ! ~~--~Bltrnt3-~-~~~ 0 K
~ . : 'U6
; - _ - JAN 3 Pt~~~t~
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f _ _ - _ , - ROGEi~ ;:•Ci i ~::i~. CLERK ~ {
` . _ . _ . i.;. ~
- = . .r; •5T. LUCIE COUNTY
~ . FLORfDA ~
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~ I FURTHER CERTIFY that i will comply with all other requirements of a legal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT ~
~ PIEICI.t, ~%~i'~~T;,~.UCtE COUiSTY, FtORIDA, perniarier~tly. ~
. • ~
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I ~ ~ = • ~ ~ . ~ ~h.~~~
t a~a I
I~ j~. , ` (Name)
! i=';i^' '~t,'~'•- - ~
•;~~-i:.` - Gforge ~ l~iahardson and M~ry M%chardson
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. _ :::.J:; -
. - - - {;CS.+~ (Address)
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' Sworn to and subscribed before me this 3 day of - J~~~ , 19
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ROGER FOITRAS ~
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CLE CIRCUlT URT Notary Public
g~ D.C. My Commission expires
(To be executed in dupiicate and original filed with Clerk Circuit Couirt, and duplicate with Tax Assessor.)
BOOK 294 - .