HomeMy WebLinkAbout0799 t t?a~nicfle and Citiser~shi - ~
Decla~ation o p
~
,
TO THE STATE AND COUNTY TAX ASSESSOR. 15~~!'~~
51. IUCiE COUNTY, FlOR10A:
This is my decla~ation of Domicile and Citizenship in the State of Florida that 1 am filinfl this day in acoordance and
in co~formity with Chapter 222, Section 222.1 F:orida Statutes. ~
1 was formerly a lega) resident of _ Chill~COthe Oh10 ~
(~ity) (~ate) '
and 1 resided at ~ Rt 5_B~x However I have changed my dort:itile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since ___14th day af
! November , 19 b6, a~ ~ res~de at Rt 4 Box 263
- (Street and Number)
>
i
FORT PIERCE, SAINT tUC1E COUNTY, HORIDA '
- ~
and this statement is to be taken as my declaration of citize~ship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facis, such as sale of property or business, or relinquishment of employment '
at former domicile, ~emoval of family to new domicile, purchase of home; etc.)
Entering 2 children in grade achool
FR~O ~ COUN
Y•~ •
~~RECORO VERIFIED . `
~
O~e;~~~ i
'66 N~ 16 PM 1 :53 ~
150Q2~
s~OGEK i•01'fRAS
, 6LERK CIRCUIT COURT
1 FURTHER CERTIFY that I will comply with al) other requiremenis of a legal rasident of this Stste.
~ ~
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT f
PIERCE, SA1NT LUCIE COUNN, fIORIDA, permanently. E
,~~i:~•- ,::,;jf . ~ ~
: . - d ~
J~• .,l', ' . . y (Name) ~
r J-. ~ - _ Clara Stef fy ~
Y . . -
_
~ ' - _ ~ (Address) ~
~
r.'-~ . .
~ ~
5worn ~to and substribed before me this 16th day of November ~ 19 66
ROGER POITRAS ~
~ CIRCUIT COURT Notary Public
~,~a~:~.~~" - i
gy O.C. My Commission expires - ,
(To be ex~suted in duplicats anei origjnal ~il~d with Cbrlc Circuit Cour~, and duplicat~ with Tax Ass~ssor.)
aooK159 ~ ~99 -
5 , , - - ~r
~ ~ ~ ~ ~ ~
~ - 1C1~: LL
~ - ..±."6_ 5r K`~ ~.i +Y'.F°``S~.
' !.€"'•v'- _ ~ x _
. . ~ ~ ..z ~ .