HomeMy WebLinkAbout0404 Declaratio~ ot Domicile and Citizenshtp ~6~91
TO THE STATE AND COUNTY TAX ASSESSOR.
51. lUC1E COUNTY, FLORI~A:
This is my declaration of Domicile a~d Citi=enship i~ the State of Florida that I am fili~g this day in aco~rdancs and
in oonformiy with Chapter 222, Section Z2?.17, Florida Statutes.
1 was forme~ly a legai resident of ~~ernnd l~eM? Jerse~/
, (City) (Stata)
and 1 resided at 31 Arl]IA Driva . However 1 hava chanfled my domitile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since 'T~a 15 day. of
_ , 19_b.8_, and ~ reside at 150 3erenata Oow~t
(Street and Number)
Port 9t. Luoie .
FORT PIERCE, SAINT LUGE COUNTY, FLORIDA '
and this statement is to be taken as my declaration of citizenship, actual legal residenoe and domicile in ihe State of Ho~ids.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at forme~ domicite, removal of family to new domicile, purchase of home, etc.) ~
~ ~
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Sntering ohildren in sohool - 9haren, Sileen and Jaoquel~rn
. FIlEO AND RECORDED?
. ST. LUCIE COUNTY. F~A.
~ 1~~~~~1F! E D ~
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. '68 AUG I4 AM !0: 44
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i ':=0:ri? FOtTRaS ~
~ CLERK CIRCUIT COURT
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1 fURTHER CERTIFY that 1 will oomply with alt other requi~ements of a legal'resident of thi: State.
~ 1 fURTHER CERTIFY that I fiave no intention to retum to my former domicjle, and I intend to remain in FORT E
PIERCE,;
SA1AT' LUCIE COUNTY, FLORIDA, permanently.
~ ~Z4~
~ - (Name) #
~ - Oarol Brennaa
~ 4
~ - - ~ . i
~ - !
' r; . ~:s,;:~~ : (Address) ;
. . .~L~'~
Sworn ~o and subsuibed before me this 14 day of Augt~et ~ 19 68
ROGER POITRAS ~ `
GLERK CIRCUIT COURT f Notary Public '
1
8y ~ D.C. My Commiu'w++ expi~es
7
ao b..,~.~.a ~ a~~~~~..~, cw.+~ c~~, and duplicat~ with Tsx A~s~ssora ;
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tip. 13-A