HomeMy WebLinkAbout2156 Oeclaratlo~ ot Domiclle and Citisensi~ip
TO THE STATE AND C4UNTY TAX ASSESSOR, 15910u
Si. WCIE COUNTY, fIORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florids that i am filin~ this dey i~ ea~ordanot and
~n oonformiy with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of JackaonvilZe ~o2y,da
i (Ciry) (Statf)
and 1 resided at _ 8228 Ae~e wve• ~ Howevsr 1 havs chan~sd my domi~le
(Streef and Number)
to and am and have been a bona fide ~esident of the Stste of Florids sinoe 1~ d~y of
x~ . 1~? , and I roside at 3221 3outh Federal H~ ght~t~ ~
(Street and Number)
FORT PIERCE, SAINT lUCIE COUNTY, FtORlDA
and this statement is to be take~~ my declaration of citizenahip, actual leflal residence and domicile in the Stat~ of Horida.
(Insert he~e any pertinent facts, such as sale of propery or business, or rellnqvi~hment of amployment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Srti~~Mng Dona~d ~.Ien-
Ranald A71en in the Jr. High School ~ILEO AND RECORDEO
ST, l.UC1E COUNTY. Fl,p,
RC ORO VERIFIEp
Bntering t Karie Allen -
Terry "
c~ar4 " all in elementarq school 'sj A~G I y~, 3; Q~
' ~-Jr~.O~
iiO~ER ?•O17RAS
CLERK CIRCUlT COURT
I FURTHER CERTIFY that 1 will oomply wHfi all other nquirements of a le~sl resident of ffiis State.
1 FURTHFR CERTIFY that I have no intentian to retum -to my former domicjlc, and 1 intend to remain in FORT
PIERCE, ~¢Itf~i•~CI~~~b~Ji~itY, FLORIDA, permanendy.
, :,~,j: : -
• . ~ . ~ " - ~ ~ ~~t~i~
. . - (nName)ra Eli
- . _ . ' ~ - Beatrice Alle I~i . 3ah )
'tj• ' • _ Y. ~`i,, .
. UL'` ~ E'+0,.~'~~~~ • (Address) .
,
Swo~n to and subscribed before me this i4th day of ~~St , 19~.
ROOER rOiTRAS ~ .
CIRCUIT COURT Notary Public
BY _ D.C. My Commiuion expiras
(Ts b~ ~c~cvhd in duplleN~ and o~inal fil~d wllb ~Meic Gr~a~it Court, and duplicat~ wilb Tax
~aiiOK~~~
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