HomeMy WebLinkAbout0702 DeClardt~o~ ot ~ornicile aed ~lizenshlp ;
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TO THE STATE ANO CWNTY TAX ASSESSOR, i
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51. LUCIE COUNTY, FlOR10A: I
This is my declaration of Domic~le and CitiZenship in the State of Flo~ida that 1 am filing this d~y in aaardence and
in confwmiy with Chapter 22Z, Section 222.17, Florida Statutss.
Scptchberg Ind~ana
! was forme~ly a legal reside~t of ,
(Ciry) (Stata) `
and 1 resided at Rt _1 8ox 15 A _ . However 1 have changed my damiGle
(Street and Number)
t~ and am and have been a bona fide resident of the Sf~te of Florida since _~__8th ' day of
_ November , 19 66 and 1 ~eside at _ 380d A~•e _ F ~
(Street and Number) -
FORT PIERCE, SAINT LUGIE COUNTY, RORIDA
and this statement is to be taken as my declaratio~ of citizenship, actual legal residence and domicile in the State of Ho~ida.
(Ir.ssrt here any pertinent fads, such as saie of p~operty or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicite, purchase of home, etc.)
~ntering Bernice Sue Fleenor in the 12th grade
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- `grt R~CpRp YERI~IE~ _
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~ NOV ~5 ~ t0•~~
66 ~ ~
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~~RK GRCUIT C ~
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; 1 FURTNER CERTIFY that I will corr~ply with ail ofher requirements of a legal reaicfent of this State.
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i .~f•~Uk?~IE1t CERTIFY that I have no intentio~ to return to my former domic~le, and I intend to remain i~ FORT j
E PIER~E; S~3tNT'tUCIE C~UNTY, FLORIDA, parmanently. ;
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. ; - (Name)
. ~ - f~~`~ Anna Fleenor
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' (Address)
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Swatn to and subxribed befare me this lSth dey of 1Vovember 19 66 _ ~
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ROGER POITRAS ~
CIRCtyT COURT Notary Public ~
2«~(wL /~tiu~'t.Z~-
BY D.C. My Gommission expires
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(To be axscuted in dupliuM and originsl fieled with CIerR Grcuit Court, :nd dupliuM with Tax Asfes~or.)
t00~(159 PACf 102 -
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