HomeMy WebLinkAbout1683 Dec~aratlon ot Domicile and Citizenship 16649'~
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. IUCiE ~OUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aooordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes. •
I was formerly a legal resident of ~~SL tte NOLthsit^liaa -
(CitY) (State)
and I residad at 6101 ~],aek ad However I have changed my domic~le
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since 4th ~.aauas~ - dey of
~a~uStd , i9~(i8, and I reside at 4D~ C4qt!
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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 pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering ~ary Wynn Teeter in lst Grade "
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ANp aE~DY
F4LE0 C~VN? '
ST. L~~o ~ v~a~~~~o
R~ C
16549~ ~ ; 06
` '68 aPR Zy AM •p,
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~ K~~'~a CU T CDURT
~ ~~RK CIR
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1 FURTHER G'HtTIFY that I wilf aomply with all other requiremenri of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domi4le, and 1 i~tend to remain in FORT
PIERCE, SAINT lUC1E COUNTY, FLORIDA, permanently.
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(Name) Mrs. Janea B. BocoCk
~
~ (Address)
~ Sworn to and subscribed before me this 24th day of Anr~ 1 ,~q_~$,
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C~E~i CN~G~J(f C6URT Notary Public '
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By ~ D.C. My Commission expires '
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(To, Bi~wNit~in duplicah snd oripinal 0 R wHM Cf~lc Gra~it Cour1, snd duplteah with Tax As~asor.) -
ao~171 „~i~81.
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