HomeMy WebLinkAbout0924 Detiaration ot Darmi~ile and Citisenship
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TO T`iE 5TATE AND COUNTY TAX ASSES50R, 13'~;~'7
Sl. LUCIE COUNTY, FLORIbA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in ecco~da~ce and
in conformity with Chapter 222, Section 222.1 Florida Statutes.
Georgetorn so Carolina
1 was formerly a legal resi~lent of - - _ -
(City) (Stata)
and I resided at -____309_ _ Pa~~_,~_tLl.~S~__. _ . However I have changed my domiG~~
(Street and Number}
to and am and have been a bona fide resident of the State of Flor+da since day of
July 65 1365 Bayshore Drivt
- - 19-----, and I reside at -
(5treet and Number)
FORT PIERC~, SAINT tUC1E COUNTY, FLdRIDA
and this statement is to be taken as my declaration af citizenship, actual legal residence and domicile in the State of Florida.
' (Insert here any Rertinent facts, such as sate of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering 2 children in Jr. bigh school
T' 2 children in Graoser school F~~ fC9 RD~D
- ~L~?OOK
, Bstablishing resideoa~
, y '65 ~!I~ I D PM 12 : I I
, ~ '~cG~•j~~;~~ ~j t
. I; :
= jr ' ROGE:it ~~"~`r~ CLEr~K
_ ~ ~ _ ST. LUCIE COUNTY,
; ' ~ ~ FLORIDA
;,n ~ :
.Iv
, ~~r .rj~ .
I FURTHER CHtT1FY that t will comply with all other requirements of a legai resiclent of this State.
I FURTNER CERTIFY tFrat ! have no intention to return to my former domi~ile, and I iniend to remain in FORT
r~fERCE, SAlNT IUCIE COUNTY, FLORIDA, permanently.
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,L~ ~ 7 c.f~r/ 7 ~
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. ,e r _ (Name)
" ~S A~Ofl ~ YI@Iic ~ B
_ • . ont
R - ~a i .
~ _ ' ~ (Address)
, - : • 4.~
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. ~ lOth August , 19 6S
_ Svycr{~ t'o and subscribed before me this ~ day af - - •
ROGER POlTRAS -
K CIRCUIT COURT ftintary Public
By 1'"''~'~ D.C. My Commission expires
(To Fr~ ~xecutad in duplicate snd origina~l ~ilsd witl~ Clerk Grcuit Court, and d~upliuts with Tax Ass~swr.)
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BOUK
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