HomeMy WebLinkAbout2954 D~~laratlon of Domlcile and Citiz~nsltip
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TO THE STATE AND C_OUNTY TAX A55ESSOR, i'~
Si. IUCtE COUNTY, FCORIDA:
This is my declaration of ~omicile and Citizenship in the State of Floricia that t am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal res~dent of YCrO. BeitCb F10Iid8___~.__
(City) (State)
and I resided at _ 1330 4th Coe~rt However I have changed my domicilt
(Street and Numk~er)
to and am and have been a bona fide resident of the State cf Fforida since I9th
_ _ day ot
~
June Fi5 . .
, 19___. and I reside at ~7Q7-__Y~r$~g~~ A?`/~.~
(Street and Nurnber) ~
FORT PIERCE, SAlNT LUCIE COUNTY, FLORIDA
nryd this statement is to be taken as my deciaration of citizensf~ip, actual fegal residence and domic+le in the State of Fforida.
(insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
~t former domicile, remot~al of famiiy to new domiciie, purchase of home, etc.)
~stablishing residency
M~ill entes ~hildrtn ia school i~ the Fal2
FfL~• RS1ED
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' ~ iTRAS CLER}C ~
-"Y'-:'~. , ROGER PG
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~ • •••'~n• ST. LUCIE COUNTY,
•
~ FLORlDA
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1 FURTFI~R CERTIFY thet I will camply with all o4her require~rients af a legal resident of fihis State.
I FURTHER CERTIFY that I have no intention to return to r~y former domi~~fe, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLURI~A, perma~~ntiy.
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~ ' (Name
s~• ~Irs. Pat Schreiber
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~ - w ay y,r ~ .
(AadrESS)
'a''., . _ . . -
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, . ~ t~ ul 19 65
Swo~n to and subscribed before me this day of
r r• , . , . , .
RCGER PAITRAS _
K ClRCQJiT COURT ~lctary Public
g ~~''~-1 D.C. My Commission expires
(To be executed in duplieats and original filed wifh Clerlc Circuit CouH, and duplicats with T~x Assessor.)
~aoK ~2~ 5~~.
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