HomeMy WebLinkAbout2450 Declaraiio~ ot Don~icile a~d Citize~ship
149235
TO THE STATE AND COUNTY TAX ASSES50R,
Sl. lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance ar?d
in confo~mity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of _____T_if~_4~~. *P~r~~a _
~C;y~ (State)
and 1 ~esided at -General L~elivery However I have changed my domitile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since ___14th__________ day of
General Delivery
OCtober , 19 66 , and I ~eside at O~e Dix~P Nnrth at Ne Br+d~e -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration~of citizenship, adual legal residence and domicile in the State of Horida.
(Insert here any perti~ent 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.)
~ntering Joyce Ann in 8th grade
" James Cecil in Blementary school
rt "
Barbara I.Ruise
" Carol Jean " ~ N
A
r :
Donna Marie " ~ 'R°,r~
o c
G Af~'.t ~A~
~ ~ ~ ~AD
A~ ~
C ~ t*1C~
-1-~ ~
Cv' W`~ ~~i
G~'~" ~~v
~ . .
1 FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
i
;
I FURTHER CERTIFY that I have no intention to return to my former domitile, and I intend to ~emain in FORT ~
i
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. +
; . ~ '
•V~/~I~, ~ ' ` ~~1~~~'~~r"'~v-v j
~ ~ • ' , - (Name) ~
. ~
• ~ ' Helen Blackburn
. - t.1• -
J f~ . c; -
i ~t ~ • ~ ' . ~ . (Address)
. , ~
f J 'Cp•'.~
17th October 66
Sworn :to and subscribed before me this day of , 19 •
ROGER POITRAS
CIRCUIT COURT Notary Public ~
gy D.C. My Commission expires
(To bs ~x~cut~d in duplicate and original filed with Gerk Grcuit Court, and dupliut~ with Tax Ass~ssor.)
aoaK 151 PACE 49
~ ~ ~ ~ ~ ~ _
~ ~ ';=;~"'~~:s ~~~~w.
, w~•-x