HomeMy WebLinkAbout1797 1'7052'?'
D~cla~atlo~ ot Domicii• and CNis~nship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Si, lUC1E COUNTY, FLORI~A:
Thts ii my declaration of~0omicile and Citiz~nship in ~tie State of Horida that 1 am fili~ thii day in aooordano~ ~nd
in conformity with Chapter 222, Sectio~ 222.17, Florida Ststut~s:
I w~s formarly a Isyal rosidsnt of -~f?~~fLAk~ drien M~'?cbiRan
(City) (Sta»)
snd 1 rosidsd at 3~ B~11eVLe . However i have char~sd my domicile
~ (Street and Number)
ro and am and have been a bona fWe rssident of the State of Florida sinos 23 rd - day of
~»ar , t9~$., and ~ roslde a~ 701 South Ocean Drive
(Street and Number)
~ na~c~, s~ ~uc~ couNnr, ao~w .
and this statarnent is to be taken as my declaration. of citizenahip, actual legal res'ider~oe and domiale in the Staro of Horida.
pr~sert here any pertinent facts, such as sale of property or business, or relinquishment of employment
st formsr domicile, removal of family ta new domicile, purchsse af t~wrne, etc.)
Bntering Child in Public School.
.
- o~
, ~ ~
~ ~7
m ~ r
i I ~0 -p mr 'Iq
A ~
~ ~ ~m2 N"
A~ A~
f ~
co ~ mC~o 0
o D - Vi
cN m' o ~
~ o °~n~
~
1 FURTHER CHtTIFY that I will oomply with all othsr requirenknh of a lepal resids~t of this Stste.
I RJRTHER CERTIFY that I have no intention to retum to my former domiGle, and i intend to remain in FORT
PIERCE, SAINT WCIE COUNTY, FLORIDA, permanently.
Ma jJohn Milea
(~lddress)
same as above
Sworn to snd subsuibed before me this 17th dsy of Sentcmber , 19~$._.
,~~J~ • ~ i••~:' . , .
' . ~ V~ ,
= , J ~ ~ Notary Publk
t-.
~~Q~.~ .
. 's~~-~~ ,c -
gy.'~ .~Y , _ ~ ~ ~ - - D.C. My Commiuion expires
" ~ r.t " ~ ~ -
~ i ~.1~5~. : ~
' • 6
/ ~ ' ~ \
/ ~ ? ~
fiA.'~ ~iw duplica/~ and ari~inal fiNd whb NKit Ck~aih Carrf, and duplic~t~ wilh Tax A~.)
. . QOR
~173 ~17
» - . ~ .