HomeMy WebLinkAbout1799 Oeclaratio~ ot ~onsicil• and Citisenship 16~:692
-iO-~iE STAYE AND COUNTY TAX ASSESSOR,
St . tUCtE COUNTY, FIORIDA:
This is my decla~ation of Domiciie and Citi=snship in the State ot Flaids that 1 am filing this day in acccrdanoe and
~n co~formiry with ~hapter 222, Sectior? 222,17, Flo~ida Statutes.
1 was formerly a legal reside.ht of ~~~a _ VA: ;
(Ciy) tState)
445 High St.
and 1 ~esided at _ However t have chan9ed my domicile
(Street and Number)
1Sth ~
so and am a~d have been a bo~a fide resident of the State of Florida since day of
Deceaber - 67 59S Airosa St.
_ _ , 19 and I ~eside at
(Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citixenship, actval legal residence and domicile in ihe State of Florida.
(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, etc.)
FILEO ~ND RECOROEO .
ST. IUCtE COUNTY. ~LA. '
E?F_C~RD b~'RI~IED lE~~r
BNrBRING CHILD IN PUBLIC SCfI00L
~~s7 oEC i e~w ~ i:~ :
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BONNIB JO FRSBMAN C8 yra)
~ti;:,L~' i'V~7RAS
' CLERK C~RCUIT COURT
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I RJRTHER CEttTlFY that 1 will oomply with all otfier requireme~is of a leyal resident of this State. ~
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E I FURTHER CERTIFY that I have no inTention to retum to my former domi~jle, and ! intend to remain in FORT
f
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name)
i FR/W g S. FRHBI~AN
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= ` `-i f ~ 18th Dece~ber 67
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, = ~ . , ~b~rqhl- ~~scribed before me this day of , ~ q .
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~ i; ~ COURT Notary Public
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~ By D.C. My Gommiuion expires
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f tfo b~ ~x~cuhd in dupiicab ~nd oripinal filsd with pKk Cirarif Couirt, and duplicst~ whh Tu Ass~ssor.) (
I. , - ~~169 ~1784 '
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