HomeMy WebLinkAbout0417 ~
~eclaragi~n ot Dorr~iCil~ ar~cl Git~zen~hip
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TO TNE STATE AND COUNTY TAX ASSESSOR, ?
Sl. IUCIC COUNTY, FLORID/1: ~
This is my declaration ofi Domicile and Citizenship in the State of Florida that I am filing this day in accordan~e and
in conformity with C~~apter 222, Section 222.17, Florida Statutes.
Recigef ield ~onnecticut
I was formerly a legal resident of - -
- _ _ -
r~~?..~ (State)
and I resided at _ _ ~ . However 1 have changed my do~'?iCile
_ _ ~2 ~lorth Str-eet------------
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ___._.~Zth day of
October_ ~q_65, and I reside at __701_Solaz Rve.
(~ireet and Number)
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FORT PIERCE, SAINT LUCIE ~OUNTY, FLCJRIDA i
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and this statement is to be taken as my cieclaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment (
~ at former domicile, removat of family to new domicile, purchase of home, etc.)
Establisiiin~ residency
- FI~ED N ~E~~C~O~f~ DED
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; . . ~ , - - ~T. LUCIE CG~?! i Y.
, , . . . F~ORID~~
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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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I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT i
i
? PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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~ - ~l"G~''~G :z^/ Zf~-~. L
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}ti~ ` . (Name) _
` ~ ~ - ~r, ~ : Edward Fr wi ler
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j - . . - _ . (,e,~lcic~s)
~ . ' - ' ~ M; ldred P. Fromwiller
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~~.Sworn to and subscribed before n~$ this 5th day of n» a Lv , 19~b~
s ROGER POITRAS
~ RK CIRCUIT C URT Notary Public
t
gy ~~~G~ D.C. My Commission expires
('to be exQCUted in duplicate and original fifed wi4 e k Circuit~Cp~, and dupliuSe with Tax Assessor.)
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