HomeMy WebLinkAbout1622 Declaration of DomiGile and Citize~shOp
TO THE STATE AND COUNTY TAX ASSESSOR, 164450
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I an: filing this day in accorda~ce and
~n conformity with Chapter 222, Settion 22~.17, Florida Statutes.
West Ham ton Beach L. I. New York._
1 was formerly a legal resident of _ _ _ p _ _ - - -
(City) (State)
and I resided at _____127 BeiLCh_ R08d _ Howeve~ 1 have changed my domiGle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 1Sth day of
101 Gardenia Ave.
Februarp 19
68_, and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citize~ship, 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 tormer domicile, removal of family to new domicile, purchase of home, etc.)
Entering-- _
Holly L Pettit in the 2nd grade
Paul Bdward in the 6th grade ~~~E~ AND RFCO
~T lUC1E COUNT R~E~.
F~ =
,
l~o '~",~,~D~,,
' 64450
~
' ~68 FEB 16 p~
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CLERK CIRCUt~ ~ ~;~g
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~ I FURTHER CERTIFY that I will mmply with all other requirements of a legal resident of this State.
a
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~ I FURTHER CERTIFY that f have no intention to return to my former domiCile, and 1 intend to remain in FORT
~
~ PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ . . ~
~ ' .
f; . c-..: . . _ , (Name)
~ . : Joan Pettit ( Mrs Robert )
a ~ ~ ~ ~ ~ - ~
- .
~ - - -
' • (Address)
~ . .
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SWoTn to and subscribed before me this 16th day of Feb. , 19 k8
~ ROGER POITRAS
- LERK CIRCUI COURT Notary Public '
- -
By D.C. My Commission expires
~ (To be executed in duplicate and original filed with Cl~rk Grcuit Court, and dupliut~ with Tax Asstssor.)
~ aooK~70 ~A~fi6~.7
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