HomeMy WebLinkAbout0364 .ts3~,i~,
Declaration ot Domicile and Citise~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA: 4
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This is my declaration of Oomicile and Cititenship in the State of Florida that I am filing this day in accordancs and ~
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in conformity with Chapte~ 222, Section 222.17, Florida Statutes. ,
I was fo~merly a legal resident of - V_~l~~~c4.n _ ~~et Virginia _
(City) (State)
and 1 resided at eo~ 71+~~ eo However I have changed my domitile '
- 8-1~-G~O~~~-,_~_
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since day of .
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_ -aTBII~_ , 19~~, and I reside at 115 8outh 13th Street
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any peninent 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.)
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Entering Robert Barker in 6th grade f
and Clint BarYer in 4th grad•
FILEO I.~JD QU' TY~F A.
ST. LUC+~
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I FURTHER CERTIFY that 1 will comply with all other requirementa of a leyal resident of tfiis State.
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I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT ~
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. {
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J~~~• ~-c.QJ ~
~ (Name) ][re. 8obert BarYer ?
(I,oie) ;
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- (Address) :
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;~`$Vv~tr~t+d;dr~s}~sfsilied before me this 2.?~'+d day of J~u~o , 19~_-
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~x = • i ~ V s ty
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~ N. .~oc~R i~o~g~s`~ =
~t ~'~~t~RK;CLR~U~~ ~~RT Notary Public '
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+ ;
~ gy ~ D.C. My Commission expires
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- (To b~ sxeatt~d in dupliuts and original ~iled wkh Cle~lc Cjrcuit Court, and dupliute with Tsx Ass~s~or.)
eaoK170 ~ 36~
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