HomeMy WebLinkAbout0753 ~ l~,at,~..7
D~ciaration of Domicil~ and Citls~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. Ll1CIE ~OUNTY, FIORIDA: .
Thi: is my deda~ation of Domicile and Ctitenship in ths State of Horida that 1 am filinq this day in aooorda~os and
in oonformity with Chapte~ 222, Sstfion 222.17, Flaids Statutes.
i was formerly a legal msidsnt of HILDBRBRAN N. C.
(~ty) (Sta»)
and 1 msided at Rt • 4 Bo~c 224A i~~
(Street and Number) ~
ro snd am and have been a bona fide reiident of the Stste of Florida sinoe 31St day of
October ,~q 68, and ~ ros;de at 3222 S. Diaie
(Straet and Number)
~ neec~, s~u~rc ~uc~ couNrr, aoRrow (
and this statement is to be taken as my declaratio~ of atinenship, actual legal residenoe and domiafe in the State of Horid~.
(Insert here any pertinent facis, such as sale of property or business, or relinquishment of employment
at fomne~ domicile, ro~rwvai of family to new domicile, purchase of horne, etc.)
BNrERING TM1C) ( 2) CHILDRBN IN PUBLIC SCHOOIS
~ ~ 1'71839 ~
DONALD RICKBY PBNNSLL (16yrs) FI~E ~
E ~o~N~y~~LA~.
ST'RF~ORO VERIFIEO
DENISB EIAINB PBNNBId. (14 yrs)
I '68 NaV i PM 2:
~ ROGER P01?R~S RT~
~ ~~ERK ~IRCUIT COU
! FURTHER CfRTIFY thst I will aomply with all other requiromsnts of a Is~aal residsnt of this State.
1 FURTHER CERTIFY thst i have rw intention to retum to my former domicale, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUMY, FLORIDA, permanentiy.
(Name)
~,.~i~?~ ~ ~~:i~~~i
t,~ i;~{~ C~~y,~. MARIB RBRRY
i
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~..-,~;~Syrc~n ~rid wbscribed before me this lst dsy ~ NOVBMSSR , 19 68 .
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COURT Notary Public
~
gy D.C. My Commiuion enpi~es
(Te b~ ~~a~l~d is duplical~ and oei~inal fiNd wbh C1~k C~aiif Cow1, and d~plkM~ wi11~ Tax A~or.) .
„ ~i74 ~ 750