HomeMy WebLinkAbout0748 ~,~S812~.
Declaration ot Domicii• and Citise~ship
~ TO'~THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE tOUNTY, FLORIDA:
This is my declaration af Domicile and Citizenship in the State of Florida that I am filiny this day In aooordenos snd
in conformity with Chapter 222, Section 222.17, Florida Stetut~s.
-1-was formerly a lega) resident of ~~~~'+t Alabana
. (City) (Stsh)
and I resided at - 1,'~1_~~gs 3trAet . However 1 h,ve chanyed my domlvle
(Street and Number)
to and am and have been a bona fide resident of the Stste of Floride sinoe 3rd dsy of
- Tnl v, 19~~, and i reside at gerz Qt~l~t P ~ Ae: ~'j~L
(Sheet and Number)
FORT PIEltCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my decia~ation of citizenship, actual leyal residence and domidls in the State of Horida.
(Insert here any pertinent fads, such as sale of property cr busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchass of home, etc.)
Entering children in School
F1LE0 ANO RECORDEO
ST.FECC~RD VERIFYEOLA.
.
'67 JUI. f 7 ~;M I I_: Sy
158~-
ii0~~i? e'OITt?.r5
CLERK CIRCUtT COURT
E
I FURTHER CERTIFY that 1 will comply with all other ~equiremenb of a leqal resident of thi: State.
• ~
I FURTHER CERTIFY that I have no intention to retum to my former domiCile, and 1 intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~ .C9 ~ ,
/~~,.i
(Name) ~
Bennsth Q. Chrietian
~ ~
~ (Address)
~
;~4wom.to and subsuibed before me this 17th day of Jul~. , 19~Z_. i
`~~~tititi:~tt:s:r.;;, ~
~ ~ • ~
~ ~ Z R0~3~~QITRAS
.J
, t-.EL~RK C~f~CtilY COURT Notary Public
= _~gj~. ~ ~ - - - - D.C. My Commiuion expires
~ - - ~
: ~t~.:: ,
~
•'.~•--`•-,r-`- 1
;
?~(~~9~ po~ivf~d 1n dupliuh and ori~inal 81~d witb Cl~eic Cinuit Courf, and duplieaN wifh Tax AtWaor.) '
~l......., • ;
~ ~ .
- . - _
w-~". .,,,-~F~ . - - - _ _ ~ ~ -
- -