HomeMy WebLinkAbout1217 Declaration ot Don~icile ~rnd Citizenshlp
TO THE STATF_ AND COUNTY TAX ASSESSOR, ~~~~~G,~ .
Sl, lUC1E COUNtY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordante and
in conformity with Chapter 222, Section 222.17, Florida Statutes. ,
t was formerly a legal ~es~denr of _ ballas Ptnn
(C~ty) ` (State)
;
and ! res+ded at Rt__1-- However I have thanged my domi~ile ~
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since _ 29t1'? day of
' _ _ ,JulY__ ~9_55., and I reside at _.___424_ SOuth 13th St~eet ~
(Street and Number) ~ ^ ~
~
FORT PIERCE, 5AINT LUCIE COUNTY, FLOtttDA ~
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and this statement is to be taken as my declaration of citizenship, actual leg~t residence and domicile in the State of Fiorida. ~
(Insert here any pertinent facis, such as sale of prpperty ar business, or relinqu"sshment of employment ~
at former dornicile, removal of family to new domicile, purchase of home, etc.) ~
~
f
~ntering children in school ~
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~ ~
~~tablishing residency ~
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6S I 7 p,M 10 ' Z 5 ~ ' . ~ . .
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ST. LUC1~ COUN7y, . ' ~ ~
r~~RIDA ~
~ ; • • • ~~~'3 .
. ~
I FURTHER CERTIFY that I will camply with all other requirements of a legal resident of this State. ,
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I FURTHER CERTIFY that ! have no intentinn to retum to my former domi~ile, and I intend to remain in FORT ~
PIERCE, SRINt LUCIE COUNTY, FLdRIDl~, permanently. ~
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~ , ~ ~
' . (v ~ ~
' . " . ( mP) ~
~ CaIa1Vn WatkinS
~ ~ • (Address)
, .
Sworn to and subscribed before me this ~7th day of ~ ~UgLtStu_ ~ 1965
ROGER POITRAS
K CIRCUIY OURT Notary Public
aY D.C. My Commis~ion expires ~
§
(To be executfd in duplicate snc0 original filed with Clerk C+rcuit Covrt, and dupfir.sts wifh Tax Ass~ssor.) . ~
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