HomeMy WebLinkAbout0292 Declaratto~ ot Dernicile and Citiz~nship r)
TO THE STATE AND COUNTY TAX ASSESSOR. 14,~18
s1. wciE couNnr, FLORIDA:
This is my decla~ation of Ocmicile and Giti:enship in the State of Florida that 1 am filinQ this day in aooordanoa a~?d
in ooriformity with Chapter 222, Section 222.17, Fio~ida Statutes.
I was forme?ly a lagal ~esident of A1baAy Georgia
t~~N) (Stats)
and I resided at 121$ Gi llionvi lle Rd Fiowever 1 have changed my domic~le
(St~eet and Numbe~)
ro and am a~d have been a bona fide ~esident of the State of Fiorida sinc~ _ lOth day of
Juue , 19 66, a~ i reside atDixie Trailot Court- So Fed.
(Street and Number)
FORT M~t~, SAINT LUCIE COUNTY. FLORIDA
and this statement is to be taken as my declarotion of citizenship, actual legal residence and domicile in the State of Horids.
(Inse~t hera any pertinent fads, such as sale of property ar business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
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Bntering Debra L Harper in the lst grade
FtLEO AND RECORDED
ST. LUCIE COUNTY. F1.N. ~
RECORD V~RlFIED '
~-~rE~a~s.~ .
'S6 24 AM II: 14 ~
14'7918
n4~:sC~ +'OITRt.S
CLERK CfRCUIT COURT
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~ 1 FURTHER CERTIFY that I will oomply with all other requirements of a lega) resident of this State.
~ 1 FURTHER CERTIFY that I have no intention to return to my fo~mer domicjle, and I intend to remain in FORT
~ PIERCE, S~INT•~tliG~;~;QI~NTY, FLORIDA, permanently.
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.~i_ (Name)
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~ . : ; ; ` ; Josie Harper
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` _ ~~•••.....••L~.?,~ (Address)
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~ Sworn to and subscribed before me this 24th day of AuguSt ~ 19 66.
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~ ROG~ POITRAS
CLERK CIRCUR C URT Notary Public '
~itic.~c.t.LL
By D.G. My Commiuion expires
(Te b~ uacutad in dupllcata and oripinal fif~d wHh Cksk Cira~h Gouef, and dupti~ah with Tax AtMS~or.)
~ ~ ~oQK153 2~~2
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