HomeMy WebLinkAbout0162 165497 :
Decla~~tion o! Domiclle and Citize~ship ;
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TO THE STATE ANO COUNTY TAX ASSESSOR, ,
Sl. IUCIE COUNTY, FIORIDA: ~
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This is my declaration of Domicile and Citizenship in the State of Florida that I am fili~g this day in accordance and 1
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in conformity with Chapte~ 222, Sectio~ 222.17, Florida Statutes. ~
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I was formerly a legal resident of -_-R4C~v~1~ _ Mzr~t,land _ '
~C;ty~ (State) ;
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and 1 resided at _ 342 W. ~d1~ODStOD Dr~ve However 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since -Z1S~----- day of
March , 19 6$ and I reside ar 1026 Sunrise Boulevard
(Street and Number)
FOI~T PIERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be taken as my declaration of citizenship, actval legal resider~ce and domicile in the State of Horida.
(Insert here any pertinent f8cts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
Selliag property in foraer dosicile... !
Establish Reaidence to enter children in i
schoal s~r~t~c
FILED AND RECORDED
ST, lUC1E C~U~~TY. FLA.
; ~ 16549`7^ ^ ~ ~
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~ '68 ~~~AR 2 5 AM 10 : 01
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~ :=t!'-;_r ~ Ol~~n%.S
~ CLERK CIRCUIT COURT ~
1 FURTHER CERTIFY that I will comply with all other requirements of a~te~al resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domitile, and t intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. /
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; ame) Samuel ReyoOld ~
~ Peterkin, Jr. ;
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. . (Address)
~ _ ~Ltil~L~ltHi:r(;~~, -
~i. ` . C :
25th 19_.~.5._.
• Santprii~ to a~fd "sybAcribed before me this day of ~rCh ,
i
~ ~ V -r _ ~ ~ ! . - {
~RT Notary Public ~
_'•'-;~~~;4~ F~O ;
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gy D.C. My Gommission expires ~
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(To b~ ~xecuhd in duplfcaN snd ori~inal Rl~d wifh C{~k Grarit Gourt, and duplicat~ witb Tax Ass~or.)
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