HomeMy WebLinkAbout0304 ~9~~lara~ion ~t ~or~~~ile ~nd ~it[~en~hip ~
TO THE STATE AND COUNTY ~AX ASSESSOR,
51. LUClF COUNTY, ~LORIDA: '~`-~~l~,~
This is my declaration of Domicile and Citizenship in tlte State of Floricfa that I am filing this day in accordance a~d
in conforrnity with Chapter 222, Section 222.17, Fiorida Statutes.
I was formerly a legal resident of _____KanS~S______ C1~ MOo
~ (City) (Siate)
and I resided at _ 3943___Oak Stre~t _ , Nowever I have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ls_t day of
_______.__NQV.emb~r_____~__, ~9
~5_, and ~ reside at __611_ South bth Street 4~
(Street and Number)
FART PIERCE, SAINT LUCIE COtlNYY, FLORiDA
~ and this statement is to be taken as my declaration of citizenship, actual lega! residence and domicile in the State of Florida.
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F (Insert here any periinent facts, such as sale of property or business, or relinquishment of employment
- at former domicile, removal of family to new domicile, purchase of home, etc.)
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: Establishing residency FI~E
J :~ND R~C RpED
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I FURTHER CERTIFY that I wil) cornply with all other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to reinain in FORT
~ ~'IERCE, SAlNT lUCIE C:JUNTY, FLORlDA, permanently.
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. " ' (N me)
• ~ Charles ~ . Sevier
~ . • • - ~
~ ~ ~ ~ t..c.rL.C~i
' ~e - • ' ~ f
- ~ ~ (Address)
, ' ~ Lucia W. Sevier
Sworn •to and subscribed before me this ` 3 rd day of _ J an u ar y ~ 9 6 6
~ ~
~GER POITRAS
LERK CIRCUI OURT Notary Public
D.C. My Commission expires
(To be executed in duplicate a~sd orisinal filed with Clerk Circuit Court, snd dupliuts with Tax Assessor.)
BOOK 135 3Q4