HomeMy WebLinkAbout0265 ls3s~s
Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicite and Citizenship in the State of Florida that 1 am filing this day in actordance and
~n conFormity with Chapter 22?, Section 222.17, Flo~ida Statutes.
Dnnville yirRinia S ~ i
I was formsrly a(egal resident of
(City) (State)
and I resided at 607 ~1Ch~0IId AV@ ~~„e~e~ 1 have changed my domic.ile
(Street and Number) ~
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to and am and have been a bona fide resident of the State of Florida since ____-.__--1st_---_---- day of ~
,
~a 6? 606 So 5th etreet i
Y__ 19~__, and 1 reside at - :
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert 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.)
FILED ANO RECOROED'
ST. LUCIE COUNTY. FLA.
Establishing residence RE CORD VER1~l~p ~
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'68 JAN I 9 AM I ~ 2
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.•.~~::Y 1', , V:7 R:.~j
CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State. :
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I FURTHER CERTIFY that I have no intention to return to my forrner domiG~e, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. O
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_ - - Pauline ~~.ne~ill
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~ ' 19th Janaury 68
~ Sworn to and subscribed before me this day of . 19 -
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~ ROGER POITRAS
~ CLERK CIRCUIT COURT Notary Public
~ ~.C.G TO dtic.,~~;l,l.-~ ,
~ gy L,G D.C. My Cammission expires
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(To bs ~xecuted in dupliute snd original filed with q~rk Grcuit Cou~, and dupliut~ with Tax Ass~ssor.) ;
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