HomeMy WebLinkAbout1282 Dectar~tion of Dor„icile and ~itizenship
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T4 TH~ STATE AND COUNTY TAX ASSESSpR,
51. LUCIE COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citize~ship in the State of Florida that I am fiiing this day in accordance and
in conformity with Chapter 222, $ection 222.17, Florida Statutes.
I was formerly a legal resident of .._=anaas_ ~~ty__ ~tissouri
(City} (5tata)
asos g 93rd S~r~ett ~
and 1 resider/ at _ _ _ . _ _ _ ~ However 1 have thanged my domiCile
(Street and Number)
10
to and am and have been a bona fide resident of the State of Flor+da since _ _ day of
1"y!Y__.__ t9 6S_, and I reside at 809 S_Indian River Drive
, (Street and Numbe~)
PORT PIERCE, SAiNT LiJC1E COUNTY, FZORtbA
and this statement is to be taken as my declaration of citizCnship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as safe nf property or business, or relinquishment of employment
at former domiule, removal of family to new domicile, purchase of home, etc.)
Ecs oEe
Entering son in lst Grade ,F~~~ ~OOK
'65 ~~1~~~~;jE~
P,O~T."~uClEttCOUNTYRK
FLORIDA
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I FURTHER CERTIFY that I will comply with all other requirements of a lega! residenf of this~~$'tatb::;`;;
.
1 FURTHER CERTlFY that I have no intention to return to my former domi~~le, and I intend to.~r~ixipin in FORT
PIER~E, SAiN7 LUCIE COUNTY, FLORIDA, permanentfy.
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~ . ' ~ ' r (Name)
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j ~ ' ` B~.rbaraSevier Ridge
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y Swwrr to and subscribed before me this _ 14 day of -______Au$~3t , lq_~.
ROGER POITRAS _ _
C K CIRC COUR'f Notary Public
By - _ D.t. My Cpmmission exp;res
(To bs ~xacutad in duplicate and origi~a! ftl~c! with Cltrk Cirtuit Covr1, and duplicate with Tax 10.s,~rssorJ
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