HomeMy WebLinkAbout2781 Deciaration ot Domicile and Citizenship ~
14g432
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Uomicile and Citize~ship in the State o~ Florida that I am filing tliis day in actordance a~d
im m~formity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~esident of __~"A~~~ TBNN .
~C;ty~ (State)
~ RT . 2 . However 1 have cha m domiG~e
and I resid~d at - - - - - - - ~9~ Y
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since 22nd day of
~~8~ 66 Minute Maid Groves-0ran~e Ave. Ext.
_ _ _ 19_-, and I reside at
(Sfreet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this stntement is to be taken as my declaration of citizenship, adual legal residence and domicile in ihe State of Horida.
(Insert here any pertinent facts, such as sale of properry or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
ENTERING ONE CHILD IN PUBLIC SCHOOL
sr~~~~~~ ~~ot
~ JA NA KIRK C 15 yrs) ECORD VERIFIE
~ '66 OCt 2 q PM I: 27
149432
~L~RK CIRCUtT COURT
~
1 FURTHER CERTIFY ihat I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intentio~ to return to my former domiG~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- ~ , ,
~~v~!:~
~ (Name) .
- ` ",~pGt
- - ~ ~ ~ ~ JESSIE C. KIRK ~
, '.i•' ` (Address) ,
f
~
Sworn to and subscribed before me this 24th day of ~TOBER ~ 19 66
ROGER POIT
C CIRCUI URT Notary Public
g ` D.C. My Commission expires
Y
(To b~ ~x ~n dupliuro and original ~iled with Cl~rk Grcuit Court, and duplieab wilh Tsx Ass~s*or.)
aooK 15 I PACE 380
_ - ~`f
, Y,;; 4 _ ; ~ ' - - - -