HomeMy WebLinkAbout0823 Oeclar~tbn ot Don~ictl• and Citisenship
~ 162044
TO THE STATE AND COUNTY TAX ASSESSOR, :
~
Sl. ltK1E COUNTY, FIORIpA:
This is my declaration of Domicile and Citizenship in th~ State of Horids that 1 am filicq this day in aooord~no~ a~d
in co~fo~mity with Chapter 224, Settion 222.17. Florida Statutes.
I was formerly a legal resident of 1Ma~1Qne Ne~+ YOrt
(City) (5tate)
t
105 Part Stree t However 1 have chanqed my domicils s
and I resided at _ -
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(Stre~t and Number) ~
b and am and have been a bons fide resident of the State of florida since 24th day of f
NQvember , 19~7 , and 1 r~ide at 3400 Ave.
(Sheet snd Number) ,
f
FORT'IERCE, SAINT LUCIE COUNTY~ i°LORIDA ~
a~d this statement is to be taken as my declaration of citiunship, actuel leqal re:idenca end domidle ln the Staro of Hotida.
(Insert here any pe?tinent fads, such as sale of property o~ business, or relinquishment of employment
at former domicile, removal of family to naw domicile, purchase of home, stc.)
~
~ntering Wiliiam in the 5th grade ST,~VCANp RE D
F/~ED E CO EO
COR
Wade in the 6th grade ~E~`~A~ ~uRIFYEp~a.
, ~s~~ }
« Richard in the 7th grade sl N~/ 21 ~
9 : sT ~
Bonnie in the 9th grade ~
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Blizabeth in the iit~ ~rade c`~RK ~~R~U1T
~pURT ~
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1 RJRTHER ~ERTlFY that I will oomply wiffi all other raquirements of e leyal residant of this State.
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I FURTHER CERTIFY that I have no intention to returrt to my former domiGle, and I intend -to remain in FORT
PIERCE, SAINT LUCIE ~COUNTY, fLORIDA, perman~ntly.
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. ~ c;'• (Name)
- - Virginia B. Boe~
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`n • . ~ t` - Wd~'ess)
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Sw~orn~ tro arid wb;uibed before me this 2?th day of Novltabei 19 67
.
ROGER rORRAS
CIRCUR COURT Notary Public
g ~~''~~Z~ D.C. My Commiuion expires _
(To b~ ~ac~arNd in duplicah and o~iain~l fil~d will~ C1~k qra~if Cou~t, aed ~ will~ Tavc AtMa~or.)
_ dQOK1V9 PAf,E 817
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