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5T tA~t484
Declaration of~~,~~~~~P
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TO TilE STAT~ AND COUNTY TAX ASSESSOR,
ST. LliCI~ COUNTY, FLORIDA:
Tllis is my declaration of I.'omlclle and Citluubip In lhe State ot Florida that I am filinl' tl1il day in accordance
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111111 in conformity with Chapter 222, Section 222,17, Florida Statukt.
I was formerly a legal reside!lt of
Winder
Georgia
State
(City)
nil I I rl'sided at
1J.1 Park Ave.
HoweVflf, I bave cbanged my domicile
(Street llnd Number)
,20th
day ot
t,. r:l"l am linG }-,I\VC been s bans fid!' resident of the State of Florida since
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li'ebruory
.~
19 63
612 So. 13th St
(Steet and Number)
. and I reaide at
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FOHT I'I~RCF.. SAINT LUCIE COUNTY, FLORIDA,
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0'1<1 this ,talement ig 10 be taken as my declaration of ciUsen~hip, actual legal reaidence and domicile in the State of Florida.
(Insert here any pertinent factll, such as sale of properly or bUline.., or rellnquilllunent of employment
nt former domicile, removal of family to new domic1e, purchaeE of bome, etc.)
Entering }.Carvin D'~ioin Skinner. Jr in the first grode
" Nancy Joy Skinner in the 8th &rode
113440
flLUl AND RECOROED
I~ ~ .om.cta' R~orcL BOOK
\903 rES 25 ~t\ tr 46
ROGER PO\1RAS. CI.~RK A 1:tJ,:/
S1. LUCIE COUlI11. flORIOt V
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I FU n fHER CERTIFY that I win register at my local addrelll when the reaistNUon books r~pen. and eo~ply
\\;,11 "II ..tlJl'f rcquirements of a legal resident of this State.
I FURTHER CERTIFY that I h1lve no intention to return to my formEr oomicUe, and I intend to remain in
FOHT I'IEHCE, SAINT LUCIE COUNTY, FLORIDA, permanentl1.
}rtlw.'7n~ ~~/
(Name)
Mrs. Warvin Skinner (Sarah)
(Addr~a)
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:;'.\ <1, n to RIlll ~uh1'cribed before me thill
25th -.
day of
Feb.
63
,19
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(To be ex<<utl'l1 In duplicate and original fIlecl with .~'c't~t." ~n. 04 dllpUea&e with Tn ~)
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ROGER POITRAS
(,LERK CIRCUIT CCTJRT
BY~ ~~:ze
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