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HomeMy WebLinkAbout0234 ~ D~cla~atlo~ of Domicii• and Cittzenship TO THE STATE ANO COIJNTY TAX ASSESSOR, ;iL~~~Q ST, IUCIE ZOUNTY, FtOR1~A: This is my daclaration of Oomicile and Citise~ship in the State of florida that 1 am filinq this day in aoo~rda~a and in oonformity with Chapt~r 22Z, Settion 222.17, Florida Statutes. I was formeriy a ~efla~ resident of Barbersville w virgiaia ~ (Ciy) (Stats) . and 1 rosided at 220 Carper Lana . However t have chan~sd my domtdie (Sheet and Numbe~) ro and am and hsve bee~ a bo~a fide reiident of the State of Florida since Zlgt day of 66 908 Boston A~.e. , , 19 , and 1 reside at (Street and Number) FORT MERC~, SAINT LUCIE COUNTY, RORIDA and this statement is to be taken as my declsration of citizenship, actusl Iagal residence and domicile in the State of Horida. (Insert here any pe~tinent facts, such as sale of property or business, or relinquishment of employmsnt . at former domitile, removel of family to new clomicile, purthase of home, etc.) Bstablishing residence and entering children~in school Dan McCarty Robert $arl~Hardman ia a teacher in E~ High School a FILED ANO RE~OR~ip~ . ST. LUCIE C~UNTY. PtA. RECOR~ VERIFIED ` ~~1C~pOY.~~ .'S6 AUG 22 PM Z: 42 ~ i ~ - - ~:o~~~`~!dr~~'~ ~ CLERK CIRCUIT COURT ' I 1 RJRTHER CERTIFY that I~II comply with all other requiremenis of s leqal resideM of this State. I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT F~ERCE. SA?~N~.WC~E COUNTY, FLORIDA, permanently. _ ,.`.~~tittf.l~Nl.~ill~~t`~,f- . O '1ti0.~U~!3T# CO ~1 f~ ~ ? s l i J.~M r c~~~~ - ' ts ;'S ~ ~ ~ (~1em~) - - ~ ~ . ' ,o:'~; Rabert Barl nardman~ = t~': ~c-'R~:-':~~-r ~ : ±t: z:.:. ia • S a~ ; ~ - . ' ~F-i ~ - f w;;. ~y ~ ~ ~S~ 1~ _ ~ :.fw ~CI!@SS~ ,;~rU. •,..~CO,,`,.~ .,,C~E_ ~ ~t,..•~ ~ , ~1' y S'~1 '~o and subsuibed before me this 22nd day of August ,~q 66 ~ tORR/1S CIRCU URT Notary Public a'`'~'~'L ak'`'~'~ D.C. My Commiss'wn expires Ro b~ ~acuhd ia duplicab snd ori~tnal Al~d with C{~ic qrsuM Cou~t, and duplieaN wilb Tax As~or.) ~ooK 153 2~34 ~ _ _ _ _ _ ' - - a;~ .,~p~, . _ ~t