HomeMy WebLinkAbout2155 Decla~ation of Dornicil• and Cltizenshlp
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORIDA: J-S~~i
This is my deciaration of Oomicile and Citizenship in the State of Florida that 1 am filinq this day in aooo~danos and
~n confo?mity with Chapter 22~, Section 222.17, Flo~ida Statutes.
1 was fo~meriy a legal resident of 1Ciaainenee ~pMdg
(City) (Stat~)
and t ~esided at , . However 1 have chan~ad my domicJle
(Straet and Number)
to and am and have been a bona fids re:ident of the State of Florida sinee _ day of
June _ ~9_$]~, and 1 r~ide at ~5 Nebraskalve.
(Straet and Number)
FORT MERCE, SAINT LUCiE COUNTY, RORIDA
nnd this statement is to be taken as my declaration of citizenship, actval legal residence and domicile in the State of Florida.
(Insert here any peninent facts, such as ssle of property or business, or retinquishment of emplaymant
at fomner domicile, removal of family to new domicile, purchsse of home, etc.)
Hathpr I.anier will enter the lOth grade
Diarie will enter 9th grade
The abov~e t~+o children ~ere enrolled in ~loodruff in Dearborn Michigan~ and are
1ox iri the-eustody oP Rsy O~rens ~o ia the grandfather. '
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1 FURTHER CERTIFY that 1 will canply with al) other roquiremenn of a leyal resident of this State.
f fURTHER CERTIfY that I have no intention to ratum to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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8~io;d'~o~i~.'3ubscribed before me this day of - ~~t ' , 19
6~.
RO~ER POITRAS
CtBtK CIRCUR COURT Notary Public
BY D.C. My Gommission expires
Ro b. .x«w.d in d~plic.r..~d ori~inal Al~d wilh a.~ic c~narff cowt, .++d d~plka~. wiM~ Tax A.M,.o.a
'6$U!f ~df.~~
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