HomeMy WebLinkAbout0711 Declaration ot Do~nicile a~d Citisenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
~l. LUCIE COUNTY, FIURIDA:
This is my declaration of Oomicile and ~itizenship in ihe State of Florida that !-am filin~ this day in aooordanoe and
~n conformiy with Chapte~ 222. Section 222.17, Flwida Statutes. ~
I was formerly a ie$~c ~as:denr of Birmingbas _ Alabama
.
. (City) (Stste)
3904 Crosshavea Dr, gahaba ~ieights
and 1 resided at - • Howevar t have char~gsd my domiGle
. (Street and Number) ` '
ro and am and have been a bona fide resident of the Stste of Ftorida since 15 ~y ~
August 66 892 Navaho Avenue
- . 19 , and I ~eside at
(Streat and Number)
~ FORT PIERCE, SAINT tUC1E COUN]Y, RORIDA •
and this statement is to be taken as my declaration of citizer~ship, actual legal ~es'~denoe and domiaie in the State of Horida.
(Inse~t here any peninent fatis, such as sale of property or business, or relinquishment of empto~yment
at former domicile, removal of family to new domicile, purchase of Farne, etc;.) .
Entering Sherry Brown in Sth Grade
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I FURTHER CERTIFY that I wil) oomply witfi atl other requirements of a legal ms'~dertt of this State. ~
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~ I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to rcmain in FORT
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, PIERCE, SAI~i1~' E~~UA~N, ftORIDA, permane~tly.
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~ . , ~.3.;~:~:;`° _ ; Lillian Bro
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~C i ~ ~>r . - ` ~ (Add~ess)
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~ Swom to and subx~ibed before me this 6 day ot September , i9-Stb
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~ ROGER POITRAS
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~ CLFRlC C UR COURT Notary Public
~ By D.C. My Commisiwn expires
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~ (To b~ ~x~cvl~d in duplicab and ori~nsl fifse! with Cl~ek C'intiif Court, aad duplicat~ wilh Tax A~a~sor.)
~ 154 1~1- - .
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