HomeMy WebLinkAbout0367 Declara4ion af Gomicile and C~tizenship
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TO THE STATE ANO COUNTY TAX ASSESSOR, ~
Sl. lUC1E COUNTY, FLORI~A:
This is my declaration of Uomicile and Citizenship in the State of Florida thst 1 am filing this day in actordahte a~d
~n confo?mity with Chapte~ 222, Section 222.17, Florida Stah~tes.
1 was formerly a legal : esident of _ _ _ ~AC~V~ . - _ _ . - KY .
(Ciy) (State)
p•~• Box 36
and ! resided at - Nowever 1 ha~e changed my domitile
• (Street a~d Number)
to and am and have been a bona fide resident of the State of Florida since ~tn day of ~
Nov~nber 66 333 Midway Rd.
- - - . 19-__, and 1 reside at _ - _
(St~eet and Number)
FORT PIERCE, SAINT LUC~E COUNTY, RORIDA
and this statem~nt is to ~ie taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
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(Insert here any pertine~t facts, such as sale of property or busi~ess, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
BI~'fERING THRfiE CHILL1RfiN IN PUBLIC SCHOOLS ~
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DREMA LYI~N HALL (11 yrs) ~
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FI~ED AND RECORDED
RHONDA NALL (10 yrs) ST. LUCIE COUNTY. FLA.
RECORO VERIFIED -
RUBIN ~rs. - t ~ yrs) 1497?57,
'ss 7 ~ : 30
iiQ::f=r~, ~•t~t?'R:.S ~
~ CLERK CIRCUIT COURT ~
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1 FURTHEtt CERTIFY that I will comply with all other reauirements of a legal resident of this State.
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1 FURTHER CERTIFIf that I have no intention to return to my former domi~ile, and i inte~d to remain in FORT ~
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_ -
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.~q.lli'.I7lilll~~j/' . ~ ~
(Name)
..~•,.•~J~~ » ~ a ~ l~'
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' ~ : ' ~ ti. ~ J~ , Mits . xEItt?~AN H.AJLL
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J ~ ~•"~a : ^ (Address)
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; '••.......-•G~~'.,~~ ?th NOVEI?~ER ' 1966
~ C S~oom.td and sut~scribed before me this day of • ~
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~ ROGER POI ~
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~ CIRC COURT Notary Public ~
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gy D.C. My Commission expires
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(To b~ ~x in dupliwM snd oripins! fiied with Clerk Grwk Court, snd dupliph with Tax Assessor.) :
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