HomeMy WebLinkAbout0154 Declaratton ot Domicile a~d Citisenship 165491
TO THE STATE AND COUNTY TAX ASSESSOR,
St. IUCtE COUNTY, FLORIDA:
This is my decla~ation of Oomicile and Citizenship in the State of Fla:~r~a that I~+m fili~ this day in aooordance and
in conformiy with Chapter 222, Section 222.17, Florida Stetutes. .
t was fo~merly a legal reside~t of Q~~R~~~~ Murphysboro I11. _
~C~ty) (State)
Rt 2 BOx 338 wever 1 have cha m domic.i~e
and 1 resided at - ~ ~9~ Y
(Sireet and Number)
to and am and have been a bona fide resident of the State of Florida since ZSth ` day of
March 68 1123 Suarise Blvd,
_ , 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 reside~ce and domicile in the State of Horida.
(Insert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of horr~e, etc.)
Bntering children in school : FILED AND RECORDED' t~
ST, LUCIE COUNTY, FLq,
F'~ C^Rr~ ~~-:.i~''~~ r~
char~es in the Sth grade 165491
Christine in the 4th grade ~6e ~R ZS ~ 9~ 29
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Eynthia in the lst grade ~~oiTR.:S
CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that I will comply with all other requirements of a legal reaident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERC.E,~~$/41~1~f:1~1~•GQ~lNTY, FLORIDA, permanently.
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- fE' . • = . . _ (Name) ~
- ~'ti' : Corinne Glover ( A~lra C11arles )
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Sworn to and subscribed before me this 25th day of ~rCh ~ ~9 68 1
ROGER POITRAS ~
CIRCUIT COURT hotary Public
gy D.C. My Commission expi~es
(To b~ ~x~cut~d in dupliut~ and oriqinsl Rled wilh CINIc Circui~ Cour~, and dupliuh with Tax A~s~.)
aooK 171 P~~ 154
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