HomeMy WebLinkAbout0914 Deciaration ot Dorrilcil• and Citl:snship
1dti100
i
TO THE STATE AND COUNTY TAX ASSESSOR. `
i
~
51. lUC1E COUNTY, FLORIDA:
This is my decla~arion of Oomicile a~d Citizenship in the State of Florida that 1 am filing this day in sooordsnoe snd
~n oonformity with ~hapter 222, Section 222.17, Florida Statutes. .
1 was formerly a legal reside+~t of Bellc C~aS3!! . ~ '
(City) ~eb)
anrl 1 residad at Rt 1 BO]c 453 . However 1 havs chanqed my domidle
(Str~et and Number)
t~ and am and have been a bona fida resident of the Stste of Flo?ida since 25t~ day af ~
f
Novemb~r , t9~Z, and ~ resitle ai ~?•~.C• Mobile Court~919 an 2Sth
. (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA •
and this statement is to be taken as my declaration of citizenship, actual legal residence anc! domicile in the State of Hotida.
(Inse~t here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, stc.)
t
Entering J udq in the 6th grade FILED AND RECOROED~ '
ST. LUCIE COUNTY, FLq,
RECARO VERIFIED i
~ 16~00 ~
'6t NOV 2 8 AM 9: 3
~
~
nOCiEri i~01TRAS ~
CLERK CIRCUIT COURT ~
~ , ~
f ~
~ ~
i ~
,
.
~
t
,
1 FURTHER CEitTIFY that I will oomply with all other requirements of s le~a) resident of this State. f
~
' ~
1 FURTHER CERTIFY that I have rw intention to return to my former domicjle, and I intend to remain in FORT }
~
PIERCE, SAINT. 4uCLE. _COl1NTY, FtORIDA, permanently. ~
.
• ' ^ ~ ~ ~
- ~ • (Name) i
~ Jim Blwooa ?
~ ~ - - _ :
_ : - ;
~ ~ ;
' (Address)
. ~ . + ~~~'1
Sworn,to and subxribed before me this 28th day of November , ~q~_.
;
ROG~ rO1TRA5 .
GRCU COURT Notary Public `
a-~-+Cc~ ~ x ir .
g _ D.~. My Gommisswn e p es
(Te b~ ~x~evl~d in dupNeat~ aed o~inal fil~d wifb CIKIt Gra~if Couet, aed duplieab with Tax Aa~or.)
a~K sss P~~ so~