HomeMy WebLinkAbout1705 ~ Declaration ot Domicil~ and Citizenship '~~~1.
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA: {
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This is my declaration of ~omicils and Citizenship in the State of Flwida that I am filinp this day in aaordanos and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
! was formerly a legal resident of Net~t Hrighton Pet~cl8ylvenia
(C~fY) (Sta»)
and 1 ~esided at ~16 Te~th ~venue . However 1 have chan9sd my domidla
(Street and Numberj
to and am and have been a bo~a fide resident of t1~e State of Florida since ._____~st day of
- M~Y , 19
6.~, and 1 ~eside at - 311 3outh 21art Street
(Sheet and Numbe?)
FORT PIERCE, SAINT lUC1E COUNTY, FLORIDA
and thi~ statement is to be taken as my decla~ation of citizenship, ectuel legal retidence e~d domiclle in the State of Horlda.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employms~t
at farmer domFcite, removal of family !o new domicile, purchase ~f home, etc.)
H~tering 2 children in school
FtLEO AND R~C~~EO~
ST.RECORD VER~E~
~e S
'61AUG g~~' ~
..15i~~-
i20GER POITRAS '
. C1.ERK CIRCUtT COUR~ -
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I fURTHER CERTIFY that I wil) oomp~y with aN other requtrements ot a leqal rssldent of~this Sfate. .
1 FURTHER CERTIFY that 1 have no intention to retum to my former domi~jte, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. .
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Mra. Ca~aer~on 8. ~rlott '
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'~bed before me this 1~th da of August
. - . Y , 19~.. ;
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- • • ' ~COURT Notary Public
" :rs....~~r~``~
~Y D.G. My Commission expires
Ro b~ ~x~cuN~d ie dup~tieab and ori~inai Al~d whh Cl~lc Cira~it CouA, and d~pliea~ wi~h Tax Ass~aor.)
eoox~s~ P,~f~705 ~
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