HomeMy WebLinkAbout0608 ~D~cla~atlo~ of Don~lail~ a~d Citiz~nship 1'~'3603
TO THE STATE M1D GOUNTY TAX ASSESSOR,
St. UJCIE COUNTY, FLORIDA: .
This is my decl~~ation of Oomicile and Citiunship in th~ Stat~ of Horida that 1 am filinq this day tn aooordanoe and
in oonformity with Chaprsr 22Z. S~ction 222.17, Florida Stafutes.
I was formerly a le~al rosid~r+t of ~o. Balt3more Ohio
Kity) (Stat~)
•nd i ~a~dsd at 20? Ao. 2nd Street ~ ~
(5trett a~d Number)
b and sm and have been a bona fide rosident of t~e Staro of Florida sinoe Jenuar9 1 _~y
, 19_~ and I reside at 524-D Route 3
(Street snd Numbsr)
1~'ORT lIQCE. tA1NT LtIC1E COUNTY, fLORIDA
and this statannent is to be taken s: my deda~atlon of atizAnship, actual iagal residenoe a~d domidle in the State of Horida.
(I~ssrt hero any pertinent facts, such as sale of property or bu:iness, or rellnquishment of empioyment
at former cbmicile, removal of family to new domicile, purchsse of home, etc.)
Entering children in public school - Billy Rag and ~lalter LaVern
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1 FURTHER CERTIFY that I wlll aomply with all ott~ nquirom~nb of a lepal rosideM of this Sta».
1 FURTHER CEftTIFY that I have no intention to retum to my forme~ domiale, ar~d 1 intend to remain in FORT
PtERCE, SAINT UKIE GOUNTY, FIORIDA, permanently.
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~'•.~~n~iubsu~b«! b~oro m~ this 8th ~y ~ January 19 69 .
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ct/ft CoNRt No~snr Public
dy O.C. My Canmissior~ ~xpint
a• M«»o~Mi i~ ~Ma~. .~i .ei.iN.~ 1N~~ wi~b a.~# araN c.wt. +~iie.~. ,rMi~ Ta~c A...««a
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