HomeMy WebLinkAbout0105~~ .,~~a±i- - -------e4~~saa-° - ~ Ssil:il-.ii..a:3if,.9al..s.,"~ -w, -- .
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Decloration of T~ ~~~ ~ j~• F , , ,
Dom~ci~e an~ Citizenship
TO THE STATE AND COUNTY TAX ~l~i3E380R~
y Saint Lua i e CO-~~ye gZ,O~A
This is my declaration of Domicile and Citizenship in the State of Florida that I am 81ing this day in
accordance, and in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of______ Gosnell_______ _____________-_-___.__ _ _ _________Arkansa_-_ __ ___
(City) (State)
end I r^~dr~ Lt,- Shy'-s~~ _~a3;~_________-__-_______-____-- - - - - - . iluwever, i save changed my domicile
(Street tend Nnanber)
to and am and have been a bona fide resident of the State of Florida since lath .day of
-----------November----------------------- 19-----~9 and I reside at-_2414__ SeR--~~S~4.4__-__----_--- ------------ -------------
(Street sad Number)
F~ t Pioroe___-- _ ________..-----~ 3t.Ltlcie---_-------- - -----County, Florida,
(City)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
.the State of Florida.
(Insert here any pertinent facts. sucl- as Hale of ppropertyy or business, or relinquishment of employment tat
former domicile, removal of family to new domicUe, purchase of home. etc.)
FnteringLinda Freeman in 6th grade
" Bobby Freeman in 8th grade
Jimigy Freeman in the 3rd grade
" Bonnie Sue Freeman in the 9th grade
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I FURTHER CER'T'IFY tl::.t I will register at my local s„dr~a whe;, the ic~aetaatiOT, ;vi,ke ;•ztper,,
w„u a.v,i,P,y rii1.71 2t.1 VLACC reyuiremeni:s of a iegai resideni oz iA16 Mate.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
ia_______Fort P~,erce____ _ ____St Lucie ______-__County, Florida,
(City) - ------o-- - --
permanently. /i .'tiJ G ~- ~-
>~ Diavid A. Freeman
------------------- -------------------Name------------------- ----------------
-~-1~° --------- -- ~~=~-~_-~~-_------
(Addrass)
Sworn to and subscribed before me thia_____-3-__-.day of
----- --~an~ery-----------------------------, A. D. 19---g~+
~_ _ ~i~~~
Notary Public State of Florida at Lrge
My Commission ezpirea___ -Jan. 15~ 1984 _
'~'~ ~ -.'tj y G~j _
;~. ' .. • j1 ~.
_, ;~ " • n -
c + 'Q
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(To be executed in duplicate and original !fled wlth G7erk
Bowen BupDl~ Co., Plant Cft1, Fla.
Girenif~"Getul,~~libd duplicate with Taz Assessor)