HomeMy WebLinkAbout0846 O~claration of Domlcil• and Ci~iz~nship ~~3~~
TO THE STATE AND COUNTY TAX ASSESSOR,
S1. lUC1E COUNTY, FlORIOA:
This i: my declantion of Oomicile and Citizenship i~ th~ Statq of Florida that I am filinq this day in eaoordano~ and
in confo?mlty with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legsl rosident of SanfQrd North Carelin~
(City) (Sta»)
end I rosided at Rt S . However 1 have charqed my domidle
(Strset and Number)
ro and am and have been a bona fide residant of the Stste of Florida sinos l lth ~y ~
January ~ ~q_ 69.and ! mside at 706 Anit a Street White City
(Street and Numbeir)
I~ORT MQCE, SAINT LtIC1E COUNTY, ROR~A
and fhis statement is to be tsken as my declaration of citizenship, actual legai residenae and domiale in the State of Horida.
pnsert here a~r pertinent facts, such as sale of property or business, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of home, etc.) ;
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` ~ntering children in school- , .
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Dou~las in the lOth grade FIl.EO AND RECQ_R
St~REC
DIE COVNT,rEO
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Brenda in the 9th grade
Sanflra in tbe 6th graaffig dAN I ~ 10:55
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~ ROG POITRAS '
' CLERK C1itCU1T COURT; ~
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1 FURTHER G~RTIFY that 1 will aomply wlth all otF~sr roquirements of a lepai r~idsnt of this State.
1 fURTHER CERTIFY thst i have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAlN7 UKIE COUNTY, H.ORIDA, permane~tly.
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S~wta tb'~i't~!'saDstribsd b~fore mt this 13t h ~ J an usrY , ~q b 9, ,
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RO~iER
li Notary Pubiic
By ~~~L D.C. My Commission ~xpi~
R~ w~aw1«i M~.w~ «i~i~al Al.r wMM CIMk CiraM C~w~, aur d~lial~ wiN~ T~oc AN.w.a i
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