HomeMy WebLinkAbout0132 ` D~cla~ation ot Domi~il• ant! Citis~nship -
TO THE
STATE AND COUNTY TAX ASSESSOR, ~ ~5~~~
Sl. lUC1E GOUNTY, FIQRIDA:
This is my detiaration of Oomicile and Citizenship i~ ths State of Florida that 1 am filinq this day in aooordanu and
in conformity with Chapter 22Z, Section 222.17, Florids Statut~s.
i was formerly a la9al rosident of ~~~t}"~` Ohio
(Ciy) (Sta»)
and 1 residad at ~2 Washitlgton lv~s• ~ . However I havs char~yed my domidle
(Stteet snd Number)
to and am and have been a bona fide res'ident of the State of Florids sinoe l~~ ~Y ~
- - Rt 1 Bluefield Road O~eechobee, Fla.
lugutst~ , 19~, and 1 reside at '
(Stroet and Number)
FORT PIERCE„ SAINT LUCIE COUNTY, ELORIDA
and this statsment is to be taken as my declaration of citizenship, actual legal residenos and domidle in the StsUe of Horida.
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pnsert here any pertinent facts, such as sale of property or business, or mlinquishment of employm~nt
at fo~ domicile, removal of family to new domicile, purchase of home, etc.)
Sntering child David ~anae in the ltth grade
David is in the care of his Grandaother ~
F~L.ED AND RECORD~B~
ST. I.UC1E COUNTY. FiJt;
: REC~RD VERIFfEO ~ -
~ - 1595`7`?'
~
f ~st auc 3 ~ a~ 9: ys
ROGER iOtTRAS ~
CLERK CIRCUIT COUR~
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1 RIRTHER CERTIFY that I will aomply wifh all othsr req~uiremenfs of a laqal resident of this State.
I FURTHER CEttTIFY that I have no intention to retum to my former domiule, and I intend to remsin in FORT
PIERCE;•S~~NT LUCIE CQllNTY, FLORIDA, permanently: j
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- I ~ ~ ~ - ° ~ - Virginia Pbater~
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~ Sworn to and subsuibed before me this 31 day of ~~u~ , 19~
Roc~e romu?s . -
GRCUR Notary Public
gy ~ D.C. My Canmission expiros
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(TO b~ ~x~w1~d ip dnplieat~ and o~in~l 91~d wilb Cl~ek Cira~N Co~rf, and d~p1iWN wHh Tax A~~.)
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