HomeMy WebLinkAbout1025 Oeclaratio~ ot Domiciie and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR, 15218'?: i
Sl. IUCiE COUNTY, FIORIDA: ~
This is my decla~ation of Domicile and Citizenship in ths State of Florida that I am filin~ this day in accordanoe and
in conformity with Ghapter 222, Section 2?2,17, Florida Statutes.
I was formerly a legal resident of 1~l'eepol`t OhiO
- - (Ciy) (Sfate)
. .
~nd 1 resided at 3 , However 1 have chanpsd my domidle
(Street and Number) '
to and am and have been a bona fide rosi~dent-of the State of Florids since day of
J~~' 102 Nor~t? 38th street
, 19~?~, and I •reside at
(Street and Number)
FORT PIERCE, SAtNT LUCIE COUNTY, FLORtDA ,
and this statement is to be taken as my declaration of citizenship, actual legal re:idencs and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property o~ businass, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of home, ett.)
~ ~nteri~ng children in achool. ! F
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Ftt,Ep ANO RECpRp ~ ~
B obby Schrieber in Hi~p school ST. LUCIF COUN1'Y
Rf CORp VERIFIE~
p~~ ~8 Schreiber in Jr Hi~ ~~2I$~
'6l JAAI 25 PM 3:32
~
~OG~~
CRERK CIRCUIT COURT
; 1 FURTHER CERTIFY that I will aomply with all other requirementt of a leqal resident of thi: State.
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~ I FURTHER CERTIFY that I have no intention to retum to my former domic.ile, and I intend to remain i~ FORT
PIEFtCE, SAINT ,LUCI~ COUNTY, FLORIDA, permanently.
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,i~ti\{ lU i 1 f f 1: R. ~
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i = l (Na
, . . Rabert Schre~~~r
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~ ' (Address)
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~Svtroneao'end subscribed before me this ~5~ day of ~ J~nua2y ~ 19 67
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F
ROGER POITRAS
; GIRCUIT C URT Notary Public
` ~.c.~.t..~i ~A[~ "
' By D.C. My Commission expires
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~ (To b~ ~acuNd jn dupiicah and ori~inal fil~d widt Cl~rk Cl~a~i! Cou~f, and ~pllcah wilb Tax As~or.)
~ ~~164 ~~024
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