HomeMy WebLinkAbout2473 C~claration ot Domicile and Citisenship
~
TO THE STATE AND COUNTY TAX ASSESSOR. 14924g
Sl. lUC1E ~OUNTY, FLORIDA: -
This is my declaratioi~ of Domicile and Citizenship in the State of Florida that I am fili~g this day in accordante and
in conformity with Chapter 222, Sectio~ 222.17, Florida Statutes.
Glascow Kentuck~?
I was formerly a legal resident of _ - - - - -
(City) (State)
and 1 resided~ at _ _ ROU t e S _ _ _ _ _ _ _ _ _ However I have changed my domiti~e
(Street and Number) ' -
to and am and have bee~ a bona fid= resident of the State of Florida since _13 day of
~o /2.=../Cc1 7~ ~R °i~ ~
October 66 Shinn Roa~
_ _ . , 19 and I reside at
(Street and Number)
FORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to be taken as my declarotion of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
~nterin~ children in Fairlawn elementar school
~?~o Awa ~~r
aT. WC~E coUNTV, , .
RECORO V~RIFIEp
_.~~o-t.L~~L.~-
~6 OCT 1~4I~ ID : 45.
y~4$
~
~ ROGER PpITRAS
. CLERK CIRCUIT COURT
I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
I F1IRTHER CERTIFY that 1 have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, S~INT LUCIE COUNTY,'FLORIDA, permanently.
. - : ~ . . . o~~~,~ _ "aP,~~v -~r! ~33
. . ~a~~~
~ ~ (Name)
. .
} . Ruth Marie Baker
~ . '
. (Address)
Sworn to and subscribed before me this 17 day of uctober , 19~2.6_.
ROGER POITRAS
LERK CIR IT COURT Notary Public
gy - D.C. My Commission expires
(To b~ ~xscuted in dupliuh and original ~il~d with Clerlc Grcuit Court, and dupliwt~ with Tax Assessor.)
600K 15~ PAGE ,72
~,~r
w~ ~.,e ~;`LL~.~ - u x ' . , 4_
_ A~`` _
_ - -