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Declaratio~ ot Dornicfle and Cittzenship i69"794
TO THE STATE AND GOUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FlOR10A:
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This is my declarotion of Domicile and Citi=enship in the State of Florida that I am fllinq this day in saoorda~ a~d ~
~n oonformity with Chapter 222, Section 222.17. Florida Statutes. ~
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I was formerly a leqal resident of Sterling Heights MichiQan ~
(City) (~a~~ i
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and I rasided at _ 35621 Impala Drive . Hcwevsr 1 have chan~ed my domiCile ~
' (Street and Number) ~
to and am and have been a bona fide ~esident of the State of Florida sinoe 1 une 2Q day of
_ , 19 68 , and 1 ~ei~de at ~t 1, Box 315, Ft. rier ce
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual lega) residence arxl domicile in the State of Horida.
qnsen he~e any pertinent fects, such as sale of property or busineu, or ~elinquishment of employment
at former domicile, removal of family to new domidle, purchase of home, etc.)
: Entering children in school
~ Michael Joseph Christensen
Steven Eric Christe~sen ~
~ FILEO AND RECOROED
ST. LUCI£ COUNTY. FLA.
R~CORO VERIFfEQ
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'08 ~~f~ Z I Pi~l I: I 3 ~
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~~~~:~a ~~o~iP~s ~ . ~
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~ CLERK CiRCUIT COURT i
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I FURTHER CERTIFY that I will oomply with ail other raquirements of a legsl'resident of thi: State.
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I FURTHER CERTIFY that I hsve no intention to retum to my former domic}le, and I intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, fIORIDA, permanently.
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= - (Name) Carl t3. Christensen
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. Sworn to and subscribed before me this 21 dsy of Augu St ~ ~q 68
ROGER POIYRAS ~
CLERK CIRCUR CO T Notary Public
gy D.G. My Commiss'wn expi~es
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(To b~ ~xecuhd in duplic~at~ and orl~inal fil~d witb CiKlc C'iKUi! Cour~, and dupliut~ with Tax Ass~ssor.)
~ d00!(1~ PACE V~7U