HomeMy WebLinkAbout0604Deolar~tion of I~ornicile a11d Gitiz~nahi~.~
TO TIIE STATE AND COUNTY TAX ASSESSOR, ~~RC 4~ ~A~ 5~~4
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3T. LUCIE COUNTY, FLORIDA: •S~. LUCIE CCUNTI', FLA.
•JJrr.r.'__- . _ _
This is my declaration of Domiclle and Citizenship In the State of Florida that I am filinY this day in accordance
and in conformit}• with Chapter 222, Sectiun 222.17,. Florida Statutes.
I was formerly a ltge;l resident of Cordel
[city]
and I resided at t~0ute 1 -- _
[StreEi and Number]
to and am s;~d have been s bon« fide resident of the Stag of Florida since
November
State
However, I have charged my domicile
10th
day of
19 ~~ ana I restae at 423 South 13th Street
[S• t nd Nwnber
c/o ~r ~lyde Ki ler
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA,
and this statement is to be taken as my declaration of citl,enshlp, actual legal residence and domicile in the State of Florida.
[Insert here any pertinent facts, such as sale of property or business, or relinquishment of .employment
at former domicile, removal of famil; :o new domicile. purchase of homE, etc•]
Entering Judy ~e Carlene in the 4th ~ra3de and
Jalses Lamont in t he 2nd grade of school.
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• _ •.E
- . • -19aJ
FILED AND RECURDED
IN .GOOK .
1962 NOV 13 AID , 9: 3 4
ROGER POITRAS, CIERK
ST. LUCIE COUNTI'LFLORIDA
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I FURTHER CERTIFY that I will register at my local address when the registration b~oks reopen, and comply
with all other re1uirements of a lega: resident of this State.
~ )<iJ~t,THER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
, ,
~ :3'lyiNT LUCIE COUNTY, FLORIDA, permanently.
FORT P •
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S~aortt!to~subscribed before me this 13th lay of _ NODember _ 19 ~~
ROGER POITi3.A5 _ _
CLERK CiRCUiT COURT Notary Fyablic
3y _S y~ U,C, hiy Commission expires
[To be executed in duplicate - e$ original filled with Clerk Circuit Court, rind duplicate wiW ~`ax Assessor]