HomeMy WebLinkAbout2908 ~j ~ t .
Declar~tio~ ot Domi~il• and Citize~ship ;
~~9~51~ i
TO THE STATE AND GOUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA:
This is my decla~ation of ~omicile and Citizenship in the State of Flo~ida that I am filiny this day in aooordanoe and
~n conformity with Chapter ?22, Section 222.17, Florida Statutes. /
I was fo~me~ly a legal ~esident of Hi1lsbQre ~hio
(City) . (State)
and I resided at _ Rt 2 BOx 1834 „.~wever I have changed my domiG~e
(Street and Number)
ro anc! am and have been a bona fide resident of the State of Florida sinoe 14th - day of
August , ~q 67 , a~ I reside at 4301 Ave J
(Street and Numbet)
FORT PIERQF, SAINT LUCIE COUNTY, ftORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stete of Horida.
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(Insert here any pe~tinent fads, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new-domicile, purchase of home, etc.)
Bntering waqne Dirk ~ndersoa in the 7th grade
" Carol Ann in the 7th grade
" Stephen Ray in the 7th grade :
_ FILED ANO RECOROEO `
ST. LUCIE COUNTY, FLA. ~
A p`~~~^ ~~-RIF!ED i
159519 ;
~st ~~+c z~ ~a : s i ~
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:.o_;L;: :•o;;~~s
I . CLERK CIRCUiT COURT
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1 FURTHER CERTIFY that 1 will aomply with all other requirements of a leyal resident of this State.
1 FURTHER GERTIFY that I have no intention to return t~ my former domiGle, and I intend to remain in FORT
PIERCE, SA(NT~:tU~IE:~'(~NTY, FLOltIDA, permanently.
~ " •'~.:z=~`i~ ' . /
: ? _ ~1 //A~ / Q~ ~ 1
_ . - ' ' i'= ~J . - (Name) ~s. ;
- , ---~-s-; : <
-~~s=4 = Clarene Mderson, t Haskel Anderson ) i
. „ . _ . • ~
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.~,_t,..;,'-:~. (Address) ;
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Sworn to and subsaibed before me this Z8th dsy of Au~juSt , 19~2.
ROGER POITRAS
CfRCUR COURT Notary Public
~ g °`t'~'''~~ ~ D.C. My Commission expires
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(To b~ ~x~cuNd in dvplleat~ aed oriyinal fll~d wflh Cl~ic Ciraiit Court, and d~plieafa with T~c As~.)
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