HomeMy WebLinkAbout0046 Deciaratlon of ~~nl~il~ a~d CitisenshEp i
TO THE STATE AND COUNTY TAX ASSESSOR. ~s155;~
Sl. tUC1E COUNTY, FLORI~A: ~
This is my declaration of Domicile a~d Citize~ship i~ ths Stats of Ftoride that 1 am filin~ this day in aocordanos and
~n conformity with Chapter 222, Section 222.17. Florida Statutes. ~
Hannau Gtrsanp
1 was formerly a iegal resident of - f (State)
(City)
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and I resided at Hdg. Battery 3rd Are~ed Div .1rt. ~~„ev~r 1 have chan9ed my domic~le i
(Street and Numbe~) ~
to and am and have been a bona fide'resident of the State of Florida since stb - daY oi ~
Nov 67 3301 ~teadow Lane ~
_ _ _ , 19 and 1 reside at ~
(Street and Number) i
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is io be taken as my declarotion of citizenship, actua! legal re:idence and domicile in the State of Horida.
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(Insert here any penirtent facis, such as sale of properry or busineu, or ~elinquishment of employmant
at formar domicile, removal of family to new domicile, pu~chase of home, etc.)
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Bnter~ng child in . 10~,b grade
RECOR~EO
F11.E0 AN~ pUN~Y. FLa• ~
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52
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~ CLERK C R~UIT C~UR~ ~
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1 FURTHER CERTIFY that I will aomply with all other requiremenri af a le~al resident of this Siate.
1 FURTHER CERTIFY that I have no intention to ~etum to my former domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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``''~,j.• If~t- ll~rj{. ^^'ti '
- ~1 . " . - ~ - - Jades Pyles ~ !
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1''• . - '1~' . (Address) .
r~~l : - C. ~ , ` t
^ 7th Novewber 6~ }
Sworn to and subscribed before me this day of . 19 i
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RO~iER 'OITRAS
CIRCUR URT Notary Public
~ nti ion ax ires
gy D.~. My Com u p
(Yo b~ ~x~cvt~rd in duplieab s~d aiQin~l fit~d w~ih Ci~lc Grwit Cass~f, and dupiiuh wiele Tax Aswasr.)
i~16~ ~ 46
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