HomeMy WebLinkAbout2897 159512
De~lasat~a~ of Dornicil• and Citizenship ~
TO THE STATE AND ~OUNTY TAX ASSESSOR, ~
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Sl. IUCIE COUNTY, FLORIDA:
This is my decla~ation of Oomicile and Citizenship in the State of Flo~ida that I am filinq this day in aooordanos and
~n cor?formity with Chapter 222, Section 222.17, Flo~ida Statutes.
Indi~ni
I was fo~merly a legal resident of ~aff~re v 11~ ~
(City) (Stsh)
and 1 resided at _ 1926 Lilly Lane . However 1 have chan~ed my domicile
(Street and Numbe~)
to and am and have been a bo~a fide resident of the State of Ftorida since Z4th day of
Augnst , ~q b? , a~ ~ re,ide at a~ -T Countr.y nb _ ;
(Sheet snd Number) i
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA j
and this statement is to be taken as my declaraYwn of citizenship, ectual legal residenoe and domicile in the State of Horida. `
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(Inseh he~e 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.) :
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Bntering Bryan i~tathex Jones in the lst grade
n ~avid Gregory in the 6th grade
~LEp q~ RE ~
n ~Cath~ G, in the 9th grade ST tUC1E `
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VER~F1,EO~' ~
59S12 ~
i ~lAUGZ
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k CIERKJ~R '~01TR~S ~
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I RJRTHER CERTIFY that I will aomply with all other requiremenn of a leyal resident of thls State. ~
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I FURTHER CERTIFY,~that 1 have no intention to retum to my former domiti~e, and I intend to remain in FORT ~
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
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. . ` - ` ~ e ~ David H. oaes ?
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~ S1~vb~n fo and subxribed befo~e me this Z8th day of ~ uSt 67 , _
ROGER POITRAS
CIRCU COURT Notary Public
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g O.C. My Comm~uion e p es
(To b~ ~x~aM~d in duplicat~ snd o~inal Rl~d wiM~ Ci~ric G~if Couet, ~nd duplieat~ witl~ Tax Asws~or.) i
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