HomeMy WebLinkAbout2702 Deciatatlon ot Domiaite and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~i~ `
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Si. LiK1E COUNTY, FlORIOA: !
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This is my declaration of Domicile and Citizenship in the State of Flo?ida that I am filing this day in accordance and ;
in conformity with Chapter 222, Section 222.17. Florida Statutes.
1 was formerly a legal resident of C~C~A_at~~--_ Qbie _
(City) (Stab)
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and I resided at 102~3 ~t~te AVe• L However 1 have changed my domiCl~e ~
(St~eet and Number) ~
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to and am and have been a bona fide resident of the State of Florida since 30th _ day of
DeCember , ~q 67 a~ I reside at Rt 4 BOx 904
- - (Street and Number)
FORT PiERCE. SAINT LUCIE ~OUNTY. RORIDA
and this statement is to be taken as my declaration of citizenship, actual lega) residerxe and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishmen~ of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering Paula Faq in the 4th grade
" Bennie in the lst grade
IMr. FulMOOd is leaving the two children in the care of
, Mildred Joyner ( his sister) w~iile he returns to ~hio for
his household fanishings
FILEO AND RECORDED ~
ST. W~IE COUNTY F '
~~CORD V ^ • CA. ~
En~~EO ;
G3~~, ;
'68 JAN 3 P~! 3: 06 ~
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..`j J'- ~ `.Ur: ~ J -
CIERK CfRCU1T COURT
I FURTHER CERTIFY that I will comply with all other requirements of a iegal resident of this State. `
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I FURTHER CERTIFY that I have no intention to ~eturn to my former domic,ile, and 1 intend to remain in FORT '
PIERCE, $AiNT LUCIE COUNTY, FLORIDA, permanently.
~.,:~t;r.: ' ~ ` .
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' V~ . . ' : . (Name)
~ . , . - , Bennie FulMOOd
~ ~ • _ . . J ~ (Address)
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' Sworn to and subscribed before me this 3rd day of January ~ 19 68
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' ROGER PORRAS ;
CIRCUIT COURT Notary Public
g a'"4'~ ~ D.C. My ~ommission expires ;
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Qo b~ uacvhd in dupliut~ and ori~inal fil~d whh Cl~lc Gra~it Court, and duplicat~ with Tax Ass~or.) ~
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