HomeMy WebLinkAbout2732 DeClaratio~ of Domicile and Citizenship ~
149395
TO THE STAIE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FlORIOA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordar~ce and
in confor:niry with Chapter 222. Section 222.17, Florida Statutes.
I was formerly a legal ~esident of MI1nd~~ -Gp^=-°a=z -
~~;ty~ (State)
and I resided at _ -~~---1 _ --~EthB ~ h8.ia---- _ - - However I have changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 16th day of
_ October ~q66 a~ ~ res~de at _ 301 D North 13th street
~ (Street and Numbe~)
FORT PIERCE, SAINT lUC1E COUNTY, FLORI~A~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flarida.
(Insert here any pertinent facts, such as sale of property or business, or reiinquishment of employment
at former domicils, removal of family to ~ew domicile, purchase of home, etc.)
Establishing residence
~
Entering Johnnie Ruth Allen in the 6th grade
" 'Lewis Stanley Allen in the 8th grade
f
BT.aLUC1~~ UNT1r~Q
ECORD VERIFIEp~'y
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OCt Z q Aly 8: S I
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~ - ~ 149395 .
~o~eR r•o~rRas ~
~ ~I.ERK CtRCU1T COURT
1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this Stste.
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
, : , , ~IdI ~i~~G~N
• . _ .•~~'i- ../{~C~
,
- . :y,. Mrs Jo~Nn ( The lma ) Allen
. . !~"r
~ - . • ~ (Address)
~ ~
- Sworn to and subscribed before me this 24tb day of UCtober , 19-(16
~ ROGER POITRAS
K CIRCUIT COURT Notary Public
gy ~'G 0.C. My Commission expires
.
lTo bs ~x~cuted in duplicsts and ori~insl fil~d with Cl~lc Grarit Court, snd duplicst~ with Tax Ass~sior.)
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