HomeMy WebLinkAbout2073 Declaration ot Domicile and Citize~shlp 14'~~~,,,~.2~
TO THE STATE ANO COUNTY TAX ASSESSOR,
51. LUCIE CaUNTY, FlOR1~A:
This is my decla~ation oi Domicile and Cititenship in the State of Florida that 1 am filing this day in acoorda~ce and
in conformity with Chapter 222~ Scctio~ 222.17, Florida Statutes.
1 was formerly a legal resident of Brimf ield Mass
(City) (Statel
Little Alu¦ p$lm Grove
and 1 rosided at _ _ . However ! have changed my domiGle
(Street and Number)
b end am and have been a bona fide resident ot the State of Florida since _ 14th day of
~
Ju1y ,~9 66 and t ~~s~d~ ~rteml 1309 Ind.ave .
~ (Street and Number)
~
FOftT r1ERCE, SAIN? LUCIE COUNTY, RORIDA !
:
and this statement is to be taken as my declaration of citizenship, actua! lega! residerxa a~d domicile in the STate of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment '
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence- will enter son in school in the fall
~ Term- ( High school )
FIL.EO ANO RECOROED
ST. LUCIE COUNTY. FI.A.
E D VERIFIED
~
'66 Jl~~ Z 7 PM I ~ 3 3 . ;
147222 ~
r~.Ot~ER r OITRI.~S
CLERK CIRCUIT COURT
1 FURTHER CER7IFY that 1 will comply v~•ith all other requirements of a legal resident of this State.
! 1 FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
I PIERCE, SAINj,,4U~'i~J~l~ll1~TY, FLORIDA, permanently.
I ~~..Y ~ ~1
~ ~
: ~ ~.'•~C`.~
I - J,;' ~ ~•,~~`S;iij;•. ~ ~
~ ~ ~ ~ • - ; . (Name)
~ A ' ~ ' f^~ . '-~6rGl
f ` i . ; Merrill H Barber j
Sf~ I . t~y i
i ' i~~~~~~~~ ' ~
UC (Address)
~ ~ . G
.r~:
Sworn to and subscribed before me this 27th day of - -Tuly , ~q 66 ,
~
! ER POITRAS
' CIRCUIT t RT Notary Public
i ~
B D.C. My Commission expires
(To b~ ~x~cvt~d in duplicst~ and ori~ina{ fil~d with Clerk Urwit Couet, snd dupticsh with Tax Ass~ssor.)
~ ~ ~i5~ ~'1~ ~
~~~`y'~ ~ ~~'o"~~x`'~ ~-.',~-~,~:a. =~t ~r:~"•~-- -
~:rt~