HomeMy WebLinkAbout0024 ~eclaration ot ~omtcile and Cittsenshlp
163496
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Oomicile and Citi=enship in the State of Floride that 1 am filing this day in acoordanoe and
in co~formity with Chapte~ 222, Section 222. i 7, Florida Statutes.
I was formerly a legai resident of Louiavilla ~iaeiesippi
(City) ° (State)
and I resided at ~ at 3. BOZ T FloWever 1 have chanQed my domicjle
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since ~ da of ~
Y ~
,
f
_ 8ecember _ , iq67 , and t reside ar 1~01 So 33rd atreat ~
(Street and Number) : j
, j
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration ot citizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any peninent fads, such as sale of property or business, or ~etinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) •
Bstabliehing residence
,
~~1E0 ANCO ECORDEO
Bntering children in achool ST.i.~~~~ UNTY,
pC COR~ VERtFtEpLA.
~6~ ~ -''~~'l~iY le,~i i
JnN-" 1~ p~ 1~ ~
16349s ~
G~ERK~~lRCWr + ~"S ~
T COURT ~
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1 FURTHER CERTIFY that ! will comply with all oiher rsquirements of a(egal resident of this State. ~
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1 FURTHER CERTIFY that 1 have ~o intention to return to my former domicjle, and 1 i~tend to remain in FORT
PIERCE, S~?INT.:~UCIE .COUNTY, FLORIDA, permanently. ,
t~;~Hll:C.tl/; . /
• ~~-ti ' ~ • ~ ~ '
- ; : . • ~-.s._ (Namie)
_ ~ ~ . . ~ ~ - : Harry g. I,inch
- - _ ~ - '
- : ` . ~
. . ~ 6~d~k
,
Sworn~to~and suburibed Fxfore me this _-~5th .Tsl2guj?y ~ ~9
day of ,
ROGER POITRAS ;
CIRCUR COURT Notary Public '
a-~1w2. 1
BY D.C. My Commiuion expires { `
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1
Ro b~ ~x~evt~d in d~pltut~ and ori~ina! fil~d with Ct~elc Cirarit Court, and dupljeah with Tax Aas~or.) ~
a~K 17o P~ z4 ~
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