HomeMy WebLinkAbout0645 Declaration of DomlCile a~d Citizenship 148134 ~ (
TQ TNE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, fIORIDA:
This is my dectaration of Oomicile and Citizenship in the State of Florida that 1 am fili~g this day in aooordance and
~n conformiy with Chapter 222. Section 222.17, Florida Statutes.
1 was formerly a legal ~es~de~,t oF - Baltimore _ Maryland
Kiry) (Stats)
2836 Hudson Street
and 1 resided at However 1 hsve changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _i 31 day of
August 66 368 Johnson Street
- _ - _ _ , 19 and I reside at
(Sireet and Number)
FORT PIERCE, SAINT LUClE COUNTY, FLORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntenng Ga~? Lee West ~ in 3rd Grade
" Martin Chauncey, 2II in lst Grade
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I FURTHER CERTIFY that I will comply with all other requirements of a(eyal resident of this State.
' I FURTHER CERTIFY that I have no intention to return to my former domi4le, and I intend to remain in FORT
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{ PIERCE, SAIN7 LUCIE COt1~YTY, FIORIDA, permanenNy.
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; . '~'~r:•.'~ ~ ~ (Name)
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i t~~ Elizabeth Carol Chaun
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. fA; ' ~,y : . (Address)
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Sworfiltp~and~lio~iscribed before me this 2 day of September ~ 19 66
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ROGER POITRAS
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; CLERK CI~ URT Notary Public
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By D.C. My Commission expires
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~ (To b~ ~xecv»d i~ dupliufs and ori8inal fited with qe~lc Grcuit Cour~, aed duplicaf~ with T~x Ass~ssor.)
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