HomeMy WebLinkAbout0418 l~~clar~tio~+ ot l~~r~icil~ ~ndl ~iti~gn~hi~ D
TU THE SYATE AND COUNTY TAX ASSESSOR, ~ A.{ f~ ~
`.t 1 . ~
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Domiciie and Citizenship in the State of Florida thaf I am filing this day in accardance and
in conformity ~vith Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident oi HaI`1.eyevills Pet1I1e
l~llyj ~rJta3c~
, and I resided at 1-13 _ _ . However I have changed my domiCile
(Street and Numbar)
to and am and have been a bona fide resideni of the State of Florida since _ day of
, and 1 rsside at __~7? Sea~tay DriVs
Auguet - - - - - - , ~ 9~~_
(Street and Number)
eORT PIER~LE, SAINT IUCIE COUNTY, FlORIDA
and this statement is to be taken as my declaration of citizenship, ac!ual legal residence and domi~ile in i~~e State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishnient of employmsnt
at former domicile, removal of family to new domicile, purchase of home, etc.)
~
s Establishing residence
~
!
~ FI
_ ~,~iND RECORDED
_.~11~1
~~~_.SOOK
~ . , . . . ' ~-`<..G~*~-
. 'S6 Jr~`~ S AM 10: 36 ~
. . . ~ _ -~~1. r~'~
~
; - ~ ~ ~ . . ~ R~G~_?t :-C~~: C~ERK
• ~ - . . Si. LUCIE COU,~JTY,
. . ' . . ~ FIORIDA ~ ~
• . • #
~ ~ " . . . . . ~ ; , ,
'k ' .
'ii
IF
- I FURTHER CERTIFY that I will comply with all other requirernents of a legaf resident of this State.
~
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and 1 intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
: . - , ,(r~ ~~e~-sJ-~~
~ . r
~ : - (Name)
- . Stanley HaClanadn
~ _ . .
. ~ ~ (Address)
. Swom to and subscribed before me this day of - JS~luetPp , lq 66.
~
~ ROGER POITRAS
IERK CIRCUI~ COURT Notary Public
By 'G ~~`~"G~ D.C. My Commission expires -
(To be ~xecu~ed in duplicate and origina{ filed with Clerk Circuit Court, and duplicate with Tax Assessor.)
aooK ~35 ~ 4~8