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.
. .
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. . ~ S7 i . ~~~~C~~ '`~Y1>i~[A/
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: . r; : . - (Name)
~ J M~•~14~l- Beatrice Fort Sirmans
• `•;::Y: :
G~,.~~ (Addrets) . .
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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~,~
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