HomeMy WebLinkAbout2045 :1i'2C612
O~claration ot Domicile and Citis~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIDA:
Thi: is my declaration of Oomicile and ~itizenship in ths State of Florida that 1 am filin~ this day in aooo~danw and
in oonformity with ~fiapter 222, Section 22~.17, Florida Ststutes.
. I was forme~ly a legal ~ident of MILLBVII.[.B NBW _TSRS3Y
(City) (Stab)
and I resided at SOUTH 4th STRBST . Hcwever I I+ave charpsd my domk3le
(Sheet and Number)
ro snd am and have been a bona fide resident of t~e Stste of Florida sinoe 27~h day of
HmYBI~BR , 19 68, and I roside at _TUANITA AVBNUB* FORT PI8RC8. PLORIDA
(5treet and Number)
fORT M~CE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declsration of citizenship, actual legal residenos and domicile in ti~e Stsro of Horida.
(Insert here any pertinent facts, such as sale of propery or business, or relinquishment of employment
at former cbmicile, removal of family to new domicile, purchase of home, etc.)
TO BNROLL CHILD IN SCHOOL
GBORGB ALLBN MILL$R lst GRADB
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1 FURTHER GERTIFY fhat i will oomply with all other roqui~b of s lepai resident of fhis State.
t FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUMY, FLORIDA, permanently.
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JANIB MILLBR (Name)
. . JitA~LA AYB~1tB
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. (Addresi)
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~ili?~ryi to e~~vb'sitr~it~d before me this 3td day of D~~~ ~q 68 ,
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7 ' ' • 4 ~ -
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lF~.~ - _
~ CLERK,ZIRCt~R' 11RT Notary Pubiic ~
. : , i
By ~.C. My Gommission expires
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(To b~ ~ocacuNd ie duplicah and a~i~inal Al~d wilb CiKk CiKUit Couef, and duplk,~h wHb Tax As~or.) ~
~ ~ oK ~.?4 ~ 20~0 ~
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