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HomeMy WebLinkAbout1544 D~claration ot Don~icile and Citisenship ~.SM~ TO THE STATE AND COUNTY TAX ASSESSOR, 51. lUC1E COUNTY, FLORIDA: ~ This is my decteration of Domicile arid Citizer~ship jn the Stats of Flalda that I am filinq this day in aooo~denos and in tonformity with Chapte~ 2Z2. Section 222.17, Florida Statut~s. 1 wes formerly a legal r~ider~t oi ~eland Geor¢ia (Ciy) (St~») and 1 resided at p•~ •~X 112 , Hcwevsr 1 haw d~anqsd my domid~e (St~eet and Number) . to and am and have been a bona fide resident of the Ststs of Florida si~ce 6tb day of F@bruary . 19,~~'L, and I restds at (Street snd m ) FORT M~CE, SAINT WCIE COUNTY, RORIDA ~ and this statement is to be taken as my daciaration of citizenship, actuel legai residenoe end domidle in the State of Horlda. (Insert here any pertinent facts, such as :ale of propsrty or business, or relinquishment of employment • at former domicile, remova! of family to new domicile, purchese of home, etc.) ~ntering Jonathan in the ?th grade R~~Q aN0 RECQRp~~ ST. lUC1E CpUNTY 3 Marsha Lpnn in the 6th arade REC1 p VERfF7L~'A'~ , . « `~~!~i~25 Martha Kay in the 3rd grade fEB e; qq ROGEF~ AOl7RAS ~ ~~RK C~RCUIT COURT 1 RIRTHER CERTIFlf that 1 will oomply with a!I other requiremenn of a ieqa! r~idsnt of this State. ' I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and t intend fo remain in FORT PIERCE, SrA1NM'LUGf.CFS4JNTY, FLORIDA, permanently. . . ti L ~ ~ i~~' - i.: , . . ~ . '~'i~' I . . ~ S7 i . ~~~~C~~ '`~Y1>i~[A/ ' . 4~ ~ : . r; : . - (Name) ~ J M~•~14~l- Beatrice Fort Sirmans • `•;::Y: : G~,.~~ (Addrets) . . . ~ . . •,~t~~~'' Sworn to and wbscribed before me thi: 7th day of FtbrvBrp ~ ~q~_, . ; ; ROG~ ~ORIFAS ' ~~urC~ Notary'Public BY ~ D.C. My Commission expires lTo b. .x.w1~a in d~pticat..n~ o~i~inr Ri~d ,wi~ R aoplic.t. wita Tax A~pora 6001(~~PAGE~,~ - - ,~~`~a.~`, ~~~~r~.a~ ;e _ _ ~~~~~s - ~~Q ~ li b