HomeMy WebLinkAbout0393 Declaration ot Domicile and Citisenship ~
TO THE STATE AND GOUNTY TAX ASSESSOR.
51. lUC1E COUNTY, FIORIDA:
i4'7954
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in aoco~danos and
in oonformity with Chapter 222, Section 222.17, Florida Statutea.
t~n?as formeriy a legal resident of a~s~Ii'~ _ T~ ~
(City) (Stah)
ar~d 1 resided at _ 811 1~iiClCihO• dr. , 1~~„~ever 1 have changed my domivle
(Street and Number)
to and am a~d have been a bona fide resident of the State of Florida since lg~ day of
1Es* Y8~ , 19 66 , and t reside at aonersl Deli~er~
(Street snd Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be take~ as my declaration of citizenship, actual legal residence and domicile in the State of Horlda.
(Insert here any pertinent facts. such as sale of property or business, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of home, etc.)
~TBRIBG OZtB CHII,D I8 PIIBLIC 3CHOOL
YIOKIS ZYlI]I REYI,B?T ( 7 y?e )
FILED AN0 RECOROG~
ST. LUCIE COUNTY. FLA.
RECOPD ti'ERIFIEO
14'7984
'66 26 AM I?: 2 I
~o ~-O±~r~:.s
CLERK CIRCUIT COURT
I RIRTHER CEftTIFY thet 1 will comply with al! other requireme~ts af a le~al resldent of this Stste.
I FURTHER CERTIFY that I have no intention to return to my former domicjte, and t intend to remain in fORT
PIERCE, SAINT LUCIE COUNN, FLORI~A, permanently.
o(.
(Name)
. ~ands Z. $e~lett
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~ ~`~$w~rrt~ ~ wbscribed before me this 26 dsy of au~ t ~ q 66 ,
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"1~oDE~ PO
~ ~ ~ C GOURT Notary Public
.
BY D.C. My Commission expires
tTo b~ ~x~cw~d in duplicat~ and ori~inal filsd with Ct~rlc Cirarit Cou~, and duplicat~ witf~ Tsx Assasor.)
~~i53 39~3
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