HomeMy WebLinkAbout1544 _ - _ - _ - - _ - - - - _
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Decl~ratlon DomiCile and Citizen~hi ~
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TO TNE STA7E AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORiv:;.
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing tt~is day in accordance and ~
in confarmi~y with Chapter 222, Section ?22.17, Florida Statutes.
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Newpaltz NeW York ~
I was formerly ~!~~al resident of -
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(Ci~y) (Sfate) ~
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and I resided at _ 3 5 M~ i p,_S t r e e t___ , . Hawever I have changed my domi~ile !
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since 19. _ day of
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January 66 . Route 3 Box 18F'I` :
- - - - - , 19~----, and I reside at
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(Street and Number) ~
FORT PIEItCE, SAINT LUCIE COUNTY, FLORIDA
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and this sfatement is to be taken as my declaration of citizenship, actual legal residence and domiciie in the Siate of Florida. ?
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(Insert here any pertinent facts, such as sale of properiy or business, or relinquishment of employment ~
~ at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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Entering daughter in 7th grade ~
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F~i.~.Q•~61P~~~RDED ~
, . IN tlilit:i~__ 300K ~
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_ _ f AM 10: 22 ~
. ~ :66 FEB ~
~ ' ' ~i S . .L~~~:Kl~j~.~ ~
M. ROGER i'vl ji~.=..;,. CLERK ~ _
~ - ~ ~ ST, LUCIE GOUNTY, ~
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• FLORIDA
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i FUR7HER CERTIFY that I will comply with all ather requirements of a legai resident of finis Siate. ~
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT ~
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PIERCE, SAIN'T~~L'UCIE~'C4}UNTY, FLORIDA, permanently. ~
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~ ~ : : / ` (Name) r ~
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~ , _ . Robert Bisenhardt ~
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. - (Address) _
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Sworn to and subscribed before me this 1 day of _ February ~ 19 66 ~
ROGER POtTRAS
CLERK C UIT COURT Notary Public
I By ~ D.C. My Commission expires
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(To be executed in duplicate and original filed with Clerk Circuit ~ourt, and duplicate with Tax Assessor.)
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