HomeMy WebLinkAbout0040 oacluation ot Domial~~ and Cit~i~nship .
TO THE STATE AN~ COUNTY T/1X ASSE550R,
S1. lt1CIE COUNTY. FlOR10A: '
This is my d~cluatio~ of Domicile and ptin~n~ip in tM Sta» of Horid~ that 1 am filin~ this day in aooordano~ ~nd
i~ oonformity with Chaptw 222, 222.17. Flork~ Statut~.
1 was formKiy • Ipal nsidtnt o# -~+~aa W~~..~
i'' 8~ ~'3~
(Gb) l~ah)
and 1 rald~d ~t P ~ Bc»c ~R6 - How~vsr 1 haw ch~r~p~d my do~nWi~
(51n~t a~d Numb~~)
to ~nd sm ~nd haw b~en a bons fide resident of tl~ StaN of Norida sinos 16tb ~y ~
Octnb,~_ , 19~$, end 1 r~side at 2201 Snuth 33rd 3tre~
• . (Strest and Nun~r)
NORT SA!!T LIK~ COIiNTY, lLORpA
and thh sbte~r?~nt 4 ro be t~ken as my dsduation of dtizen~ip, actual le~al r~sidenos and domkile in ths Stst~ of Horida.
qraKt h~n any pKtinent facK, wch as sale of property or businsss, or rolinqui~rr?snt of empla'Ym~nt
at ~orrnK domidls, rerrwval of family to new domiak, purcha~ of horne. ~1c.) '
Bntering Deibert Randall Harv~y in lst grade
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~t~ . ~ RE ~
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E,. r~~„~1~g °
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- '68 a~T 18 ANI 9 .
, ~ 4i0EE~ F81~RAS
~ i c~EaK ~~a£u~# couRT
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~n~ ~fit ~ M/f~~ 001f1~r W~1tf Of~Nf fOQ1~~fM11~f11s Of f~~Oflt O'~ ~I~i ShtO.
1 fURTHER CERTIFY that I have. no intention ro mtum to my former daniale, and I int~end to romain in FORT
PIERCE, SAlNT UKIE COUNTY, fLORI~A, permansnHy.
L~i , :
(~~)Daqton~ andall Harvey
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~~~•p'~;~;~ r,,,~ iRth ~ October , 19~.
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.~_i~11RT ~ NOfary AlbiiC
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sy ~ ~ ' o.c. ~Ny? c~a~o~,
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tTi M~e~ M~M~s1r a~i ~i~i~~i A1~1 will~ E#~k CI~rr11 C~~, ~i ~ wMM Tioc Aw~~~
t~i'~4 ~ ~0
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