HomeMy WebLinkAbout1500 De~laration ot Domicile and Citizenship 16~36$
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Gr8T2g@ pB2'$_ _ j~~
~City) (StaTe)
and I resided at-_____ 534 NOrth W8101ti However 1 have changed m~demitile
(Street and Number) -
to and am and have been a bona fide resident of the State of Florida since 13th day of
~p,b. _ , 19_ and I reside at __180!~H8V811ri8 Ap6. .
(Street ~nd Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of FlorEda.
(Insert here any pertinent facts, such as sale of properry or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing reaidence and entering children in school
FILED QNO RECOROED
ST. ~UCIE Ct!Ut:TY. FLA•
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'68 FtQ 14 P' s4
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j CL~nK CIRCUI7 COURT
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~ 1 FURTHER CERTIFIf that I will comply with all other requirements of a lega) resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to ~eturn to my former domiule, and I intend to remain in FORT
~ POERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ CG'/f~;~`,rr ~ ~Na e)
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~ ' c' - ~ = Karen J. Y~nke ( Dfirrs. ~sruce )
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_ . ~ z (Address)
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~ Sworn to and subscribed before me this 14th day of Feb• , 19 -
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ROGER POITRAS
- K CtRCU1T COURT Notary Public
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~ gy D.C. My Commission expires
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(To be executed in duplicste and original file$ v~it ~lerk Grcuit Court, and dupliuts with Tax Assessor.)
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