HomeMy WebLinkAbout2154 166833
Declaratio~ ot Domicile and Cittze~ship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
t
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of ~omicile and Citizenship in the State of Florida that I am filing this day in actordance and
in conformity with Chapte~ 222, Sectio~ 222.17, Floricla Statutes.
Brunswick Georgia
1 was formerly a legal resident of - -
~~;y~ (State)
and I resided at 1334 Puritaa Avecluc However I hbve changed my domi~ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 2~d day of
_.___May _ ,~q
(z8, and 1 reside a+ 615 Ocean Drive ~
(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 ihe State of Horida.
(Insert here any pertinent facis, such as sale of property or busineu, or ~elinquishment of employme~t
at former domicile, removal of family to new domicite, purchase of home, etc.)
E ntering Charies Druri in the Sth grade of St. Lucie
County Public Schools
FfLEB AND RECORdE~
ST. LUCIE COUNI'Y. ~LA:`
RFC~RD VERI~IED _
166833
' . •68 Y s AM II: 2
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~ , RC]~ER s'•017RAS
~ CLERK CIRCUIT COURT
I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PiERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
~ ~
~ (Name) rrp Frey~
~
d,
~ (Address) e an r i ve
~ Ft. Pierce
~ Swo~~:taieyq~svbsuibed before me this 6th day of May ~ 19 68
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' . . :
, ~-'~ER POITR/?S ~ .
C~tK CIRCUR Efiql~t Notary Public
t ~ =
gy D.C. My Commission expires
i ? ti~- .
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(To b~ ~x~cut~ in dupliuts and oripinal Rl~d with q~rlc Grwit r1, and duplicat~ with Tsx Ass~ssor.)
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