HomeMy WebLinkAbout2784 _ oeclar~tion ot Dorni~lle and Citizenship ;~59432
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TO THE STATE AND COUNTY TAX ASSESSOR. `
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Sl. WCtE COUNTY, FLORIDA: *
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This is my declarotion of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordance and ;
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in conformity with Chapter 222, Section 222.17, Florida Statutes.
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I was formerly a legal resident of rges~-A
(Ciry) (Stah)
and I resided at - ~ 2 Box 5 Pi`etor'is ~CY'es . However I have chanfled my domidle
(Street and Numbe~) '
to and am and have been a bona fide resident of the Stste of Florida since lst day of
_ Jt11~ 19
6Z, and I re:ide at 9Q4 Crat~?fYsh C~rt ~ ~
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FORT PIERCE, SAINT LUCtE COUNTY, RORIDA .
and this statement is to be taken as my declaration of citizenship, actual legal reaidenos and domicile in the Staro of Horida. `
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
I~lntering Frederick Cotten Camer in the 2n~d grade
FtL.EO ANO RECO~'
~ ST. IUCIE COUNTY. FLA. '
RECORD VFRIFIED
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'6T AUG 25 PN !2: 10 F
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~ fSOJ{~R 1 Rh5
` CLERK CIRCUIT COURT
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e 1 RJRTHER CERTIFY that I will aomply with all other raquiremenK of a Isyal resident of thi: State.
I. FURTkIER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT
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PIERGE~ ;~~f'N:.~~lE.:COUNTY, FLORI~A, permanently.
1:~. , CO,~`~i,~'
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• ' ~ i r ' (Name)
" r: Hazel Caner ( Fred C. Co~ner Jr)
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' Sworn to and subscribed before me this 25th day of wugust ~ ~~i7
ROGER PORRAS
CIRCUR C URT Notary Public
gy D.C. My Commission expires
(To b~ ~x~euhd in dupliub and ori~inal Rl~d with Cl~lc Cirwit Courf, and duplicaf~ with Tax Ass~s~or.)
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