HomeMy WebLinkAbout1172 DaClaration of Dotric~le a~d Citizenship 13~~1s;~
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUN7Y, FLORIDA:
This is my declaration of bomicife and Citizenship in the 5tate of Florida that I am filing i!~is day in accordante and
in conformity with Chapter 222, Section 222.17, Florida Statutes. , ~
t was formerly a legal resident of Ma~~~~s~ Geor ia
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~City~ (State)
and I resided at Q~$.. ~e~ _~~!l~ - - - . However I have changed my domi~ik
(Street and Number)
to and am and have been a b~na fide resident of the 5tat~ of Flor3da since ~1~h day of
-,jun~ _ 19_._ 65 ant! I reside at .._1606 HivSnn'l Avt
(Street and Number)
,
PORT PIERCE, SAINT LUC{E COUNTY, FLORIDA
and this s'atement is to be taken as my declaratian of citizenship, actual legal residente and domicile in ihe Stat~ of Florida.
(Insert here any pertinent facts. s~ch as sale of property ar business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering c~iildren in school
FIt~ED ANO REC8R~E9
• ~_~OOK
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'65 ~4UG I 6 PM~3 : I 0 .
13~3~. ~ ,
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ROGEn ~ i r:~S. C~ERK . a;. - ~
ST. LUCIE COUNTY, 'A ~
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FLORIDA '
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f FURTHER CERTIFI( that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi4ile, and I intend to remain in FORT
PIEitCE, SAINT ll~~~'~C7UNTY, FLORIDA, permanently.
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(Name)
. ~ Louise White
, ~ . :
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~ • . (Address)
Swom to and subscriberl before me this _16th ~ day of ` ~U~USt ,;q bs .
ROGER P017RAS -
K CIRCUiT CQ~JRT Notary Pubiic
1_~ y
d'
g~/ ~ Z~ _ D.C. My Commission expires -
(To be ~xecutsd in duplicate and original fileci with Clerk Cirw:: ^.ourt, snd duplicats with 7ax Assessor.)
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