HomeMy WebLinkAbout2174 Declaratto~ ot ~omicil~ and Citis~nship ~~9=
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. tUCIE COUNTY, FLORIDA: .
Thi: is my declaration of Oomicile and Citi=enship in the State of Florid~ that 1~m filin~ thit day in ~oocrdano~ e~d
in confo~mity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was formerly a legal ~esident of Tndi n,~
(city) (St~t~)
snd 1 resided at - B~ ~12 ~npblebur8 . However 1 h~ve thanqsd my domi4:~
(SNSet and Number)
b and am and have been a bona fide rosident of the Stste of Florida sinoe l~h " day of
Febrna~ _ , 19~Z, and~ 1 reside at x°dera Mobile Holnea
~ (Sheet and Number)
~ORT r1ERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be taken as my declaration of citisenship, actusl legal residenos and domidle i~ the State of Horida.
l
(Inse~t here any pe~tinent facts, such as sale of propery or bu:iness, or rellnquishment of employment `
at former domicile, removal of family to new domicile, purthase of homs, etc.)
Eritering Vivian Leigh Purlee in the lat grade ;
- F~~ED
ST. I.~~~E
~ ~NTy
F~
R~ CpRp ~ER?F~ED ~A.
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~~~14
13,,~~~y 9 ~ 5 ~
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~
1 RIRTHER GERTIFY that I will aomply with all other requiremsnt: ~f a le~al rssidsnt of fhis Sfate.
~ - t fURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
~ PIERCE; ,$Alt!1`~`IUCtE, COUNTY, FLORIDA, permanently.
3 : ~ ~ , ~ ~'~r~'~,''. • - ' • .
~ C~.:•'~ , l it`~i~LGGC~ ...lG~ li.
~ ~ -'_t ~ ~
f c:~ (Name)
~ ~ s;'..-~ ~ Jauice Ptu~lee
~ `;~'i~=~';.-.,., ; ~ ~
~ - _ ' Hra Grant Pnrlee
• ' • • • 4~ . ~~v (/e?ddreis)
_ E0
~ Swor~ to and subscribed before me this 13~ day of ~ .~~3--•
~
~eoa~e ron~?s -
~ CiRCU1oT
COURT Notary Public
~ ~a.~,~Cc.L Tr ~wsE.(.~
gy O.C. My Commiuion expiret
(To b~ ~aM~d in dup~cat~ an~ ori~inal Al~d with Cl~rlc Cire~if Court, snd dupNeal~ wilh Tax As~o~.)
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