HomeMy WebLinkAbout0794 aclaratto~ ot Don~iall~ a~d Cltls~nship ~~~0
TO THE STATE AND COUNTY TAX AS.SESSOR,
Si. ItKIE GOUNTY, FIORiDa - -
This i: my dadaration of Domicile and ~timnship ln th~ Stats of Florid~ th~t I am Hli~p this day in aooorda~a ~nd
in conformily with Chapter 22Z. Ssttio~ 222.17, Florida Statut~s.
1 was formsrly a Ipal rosid~nt of 1r13lford Maas. ~
~qty) (Sta»)
a~ at 52 Claf lin S~ reet
(Stro~t and NumbK)
to and am and hsve been a bona ftd~ rosid~nt of the Staro of Florida sinoe aSth
~.t~ , 19_~.$, and I roside at Box 315 U S #f 1 Rt . 1
(Strse~ and Number)
!'ORT SAINT LNCiE COUNTY, I~IORqA
end this :tatemsnt is ro be taksn as my dsdaration of dtizenship, actual le~aal res'idenoe and domkile in ths State af Florid~.
pnsert here any pertinent fads, such as sale of property or business, or relinquishm~~?t of an~lo~yrt~M
at former domicile, romoval of family to new dcmkile, purchase of homs, Nc.)
Bntering Deiek S4ege1 in 2nd grade
- F1LE0 AND RECORD~D
" Blizabeth Anne in the 4th grade ST. LUCIE COUNTY. FLA.
RECORO VERIFIED
" Bernard ~Jon in the 6th grade ~~$sO
'6$ ~i'f~ 23 PH !Z : 3y
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I fZOGER r O17RAS
~ CLERK CIRCUIT COURT
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I FURTI~IER CHtTiFY th~t 1 wili oomply with ali atF~ nqui~b of a Ipal ~idem of th~ Sta».
I RJRTHER CERTIFY that I have no intention to retum to my fo~mer domiqle, and I intend to remain in FORT
PIERCE. SAINT LUCIE COUNTY, FLORIDA, permansntly.
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~ l' ~ ~etty L. Siegel ~
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',~~,~1~~'~ ~ ~ ~ 23rd ~r ~ August ~q 68,
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ROO! ~OflRA:
CI~K GOIIRf Notary P~Ik
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