HomeMy WebLinkAbout1078 ~ ~
Declaration of Da~nlcile and Ctti:enship
1~01~3 ~
TO THE STATE AND ~OUNTY TRX ASSESSOR.
Sl. WCIE COUNTY, FIORiDA:
This is my detlaration of DomicilB anci Citizenship in tha State of F{orida that 1 am fili~g this day in aooordanto and
in conformity with Chapter 222, Sectior~ 222.17, Flo~ida Statutes. .
I wa= forme?ly a ~ega~ ~esider~t of Tb~masville Geo~ia _
cc~~?) (stzro)
arKl 1 res~ded ar 506 Campbell St reet Howe~er i ha~e chan9ed my domidle
~ (Street and Numbe~)
to a~d am and have been a~bona fide resident of the State of Florida since - 6th _ day of
November 66 Rt 2 Box ~1132 A
_ 19 , and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citize~ship, actual legai residence and domicile in the State of Horida.
(Inse~t here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) .
- ~D Ai?~D RE
8T. L•UCEE COdNTY~~.
Entering two chi2dren in school R£COR01rER~F~p~'•~
'ss NOV 23 PM 3:22
- 1•~O193
~'cOGER 'OITR~.S
~ ~ 6LERK CIRCUlT COURT
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I RJRTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
f FURTHEt~.CERTIFY that I have no intention to return to my former domiG~e, and I intend to remain in FOkT
PIERCE, SAI~~1~`' :.~~'COlJN7Y; ~LORIDA, permanently.
•~u'~~ ~ • t ' ~ ( ` - • r ~,~•.'v
- :F;, , ~:S}' k
~ a.ldJ
. :r " .`-':~a j ' L - . (Name)
. Grace Harris
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.~ii~tit- _
' ;ri.~::•G~.~~: (Address)
. '
Sworn to and subscribed before me this 23rd day of November , 19 66
ROGER POITRAS
CIRCU{T t RT Notary Public
gy D.C. _ My Commissian expires
(To b~ nacut~d in duplicsta snd ori9insl filed with Clerlc Grw3t Court, and duplica» with Tax #1ss~sor.)
- a~oK 159 PAGE 4?8 -
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