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HomeMy WebLinkAbout0382 DeClaration ot Domicile and Citisenshtp ~ 14'~'3 TO THE StATE AND COUNTY TAX ASSESSOR, Sj. LUCIE COUNTY, FIORIDA: This is my declaration of ~omicile and Citi=enahip in the State of Florida that 1 am filing this day in acaordanoe and in conformiy with Chapter 222, Section 222.17. Florida Statutea. 1 was formerly a legal resident of ~ Bath _ pa~ (Ciy) (Stats) and 1 resided at Rt. 1 BOX 36 ~„„ever t have cha~nged my domic.ile (St~eet and Number) to and am and have been a bona fide resident of the State of Florida since 18th day of August 19/'/~ ~~s~ 1403 Plorida A~e. , (p1~, de at _ (Street a~d Number) fORT MERCE, SAINT l~.~CIE COUNTY, RORIDA and this statement ia to be taken as my declaration of citizenship, actual lega! residerxe a~d domiclle in the State of Horids. (Inseri here any pertinent facts, such as sale of property or business, or ~elinquishment of employment at fwmer domicile, removal of family to new domicile, purchase of home, etc.) - Bntering three (3) children in pubiic Schools S. HAROLD WpRNBR (17yrs) ~II.ED AND RE s~. LUCIE CDUN~~. DEBRA LgB BOND (9 qrs) ~ECO ~ VER~FIED Jx. CURTIS LBROY ~C?ND,(8 qrs) : 66 AJG 26 AM 9: 35 14~y`~'3 F:O;; t R i~OfTRt.S CLERK CIRCUIT COURT 1 R1R7HER CERTIFY that I wil! comply with all other requirements of a lega) resident of this State. i • ~ ! FURTHER CERTIFY that I have no intention to return to my former domicjle, and t intend to remain in FORT f ~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. t ~ t ~ ~ (Na ' F - ~~:T ~i ~}pr~T ~ ~ ,'J •w CVRi 1~ Z1~Y LBROY BOND E ~~'.i .•S~1U~ ~ '••vG : - ~J /c~ :9 - t ~ : ~ ~ (Address) ';f , _ . , - V'~. ~ = ~ : ~ : , : • . ' 26th August 66 ~~.~;d ai~d,subscribed before me this day ot , i9 . i.•~~'' ~~1. , _ . . ; f~~v ~ ~ <f `~\i~~~ . t ` ~ r,•~ ~ - G . ' 'rf• •~~~~ER PO ~ CLERK IRCU URT Notary Public ~ . - ~ BY ~.C. My Commission expires E € • ~ ~ (To b~ ~x~cuhd in dupljcat~ and ori~inal Rl~d with C{~tc Ci~wh Cour~, and duplicat~ wifh Tax Ass~or.j ~ i ~ eo K153 38z - ~ . . - c . _ . ~r Y _ a _ _ _ _ - - _ _ - - - - _ _ x ~:Y~~ ~