HomeMy WebLinkAbout2921 Declaration ot Domicila and Citizenship
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TO.THE STATE AND GOUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA: .
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filiny this day in aao~rdanos and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Ro~ne Aev York
_ (Ciy) (Sta»)
and I ~esided at 5992 Earie Blvd Weet _~Wevef 1 have changed my domitile
(Street and Number)
29th ;
to and am and have been a bo~a fide resident of the State of Florida since day of ;
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l~808~ Sunrise Blvd,
_ .Tulv___ , 19_~22_._, and 1 re:ide at ;
, .(Street and Number) F
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal re:idence and domidle in the State of Florida. ~
(Insert here any pe~tinent facts, 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.)
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Fhtering Darsie P Se~nour in the 5th grade FILED AND RECORDEQ '
ST. LUCIE COUNTY. FI.A. ;
" Pau3a Ann in the ltth grade c?F:C~~~ ~«RfFIEO ~
! Eamala in the 3~ grade 15952;~ ~
'6~ ~l~G 28 PM 2: 3 I ~
~ Denise Catherine in the lst grade `'~~e~.~~
;O'.::'r. i=01?R~S I
CLEFZK ClRCUIT COURT ~
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1 FURTHER CERTIFY that I will aomply with all other requirements of a leyal resident of this State.
I FURTHER CERTIFY that I have no intention b retum to my former domicjle, and I intend to ~emain in FORT
:~3::~;;., ~ -
PIERCE;',5R1T1'~;1t
~~;~OUNTY, FLORIDA, permanently. . '
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: ~ Joy-ce Seymour ( I~rs~ arsie )
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Sworn to and subsuibed before me this 28th day of ~~8t . 1967 •
ROGER POITRAS
CIRCUIT C RT Notary Public ~
i
gy D.C. My ~ommiss~on exp~res ,
(To b~ ~x~eubd in e~rplicat~ and ori~insl fibd with Cl~elc qraril Cour1, and duplicah wiN~ Tax Ast~a~er.)
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