HomeMy WebLinkAbout2337 Declaration ot Domtcife and C~tizenship .1530i0
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE GOUNTY, FIORIDA:
This is my declaration of Oomicile and Citi:enship in the State of Florida that I am filin~ this day 3n scoo~dence and
in confo~mity with Chapte~ 222, Section 222.17, Florida Statutes.
I was formerly a legal ~esident of Vivian ^~+isiana -
~C~ty~ (Stats)
407 w Nevada
and 1 resided at - - However 1 hsve chanyed my damitile
(Straet and Number)
to and am and have bee~ a bona fide tesident of the State of Florida si~te 24 day of
_ ,~19 67 and I roside at 5600 S. Fede~ al Highwav -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, ELORIDA -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facfs, such as sale of propeny or business, or relinquishment of employment
- st former domicile, removal of family to new domicile, purchase of home, etc.)
FIIED AND RECORB p`
ST. l,UC1E COUtVTY
RECORD V RIFI~
d ~~xP"" ` •
- Entering son~ in 2nd Grade '6T FEB 27
0 ~ 45
S3~i0
~iO~ER .OITRAS
CLEqK ~~RCUIT COURT
~
1 FURTHER CERTIFY that I will oomply with all other requirements of a legal resident of thia State.
1 FURTHER .CEitT1fY that I have no intention to ~eturn to my former domiCi~e, and I intend to remain in FORT
-,tr:::le:t . • ~
PIERCE, SAIl~11~~~tl~IE ~b4,NTY. FLORIDA, permanently.
: - - . ~L
' ~ ~ ~ 1 ~ ~ ~ ~ ~.l6a~L~:--
~ ` ~ - -5 ~ (Name)
_ .
" ~
~ Connie Poindexter
. - t .
~ C!1., ~ (Address)
Sworn to and suburibed before me this 27 day of February , 19~Z.
ROGER POITRAS
CI~RK IRCUIT COURT Notary Public
gy D.C. My Gommission expires
(To b~ ~x~ait~d ie duplieat~ and oriyinal Rl~d wilh Cl~rlc Grwh Gouet, and dupli~Tax AssKSOr.)
~0~164 ~~2333 -
i~s.j?;+t 5 . . _ . . .~~Trv
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