HomeMy WebLinkAbout1220 acla~atio~ ot ~o~nlcil~ and Citis~nship
TO THE STATE AND GOUNTY TAX ASSESSOR, 1~QOa~
Sl. lUC1E COUNTY, FLORIDA:
This is my d~clar~tion of Domicile a~d Citizenship i~ th~ Stat~ of Florida that 1 am filin~ this day in aooordana ind
in oonfamiiy with Chapter ZZ2, Settio~ Z2Z.17, Horid~ Statut~s.
~ was form.rly a Ipal resident of Hastings Nebraaka
(~ity) • (Sta»)
and 1~~d~d at Rt' 2+ Hastings i~~~~~ mydomkil~
(Stroet and Numbsr)
ro~nd am and haw been a bona flde rosident of tM State of Florida sjnoe Jan _ 20 day of
~ ~9 69 ~ a~ ~ Rt. 1~ Box 811
(Stresf snd NumbK)
lORT NQCE, iAWT LUC~ COUNTY, fLOR1~A '
snd this stat8ment ts to be taken as my dedaration of atizenship, actual le~al reside~oe a~d domicile in the State of Horiida.
qnsert hsre any pertinent facts, such as sale of properry or business, or rolinquishment of amployment
at form~ domicile, ronwval of family to ~ew domicile, purchase of twrris, etc.)
entering 1Cevin James Keiser in public school
fILEO ANQ RECQRDEO
ST. LUCIE COUNTY. Fl~.
R~CORD V~RlF~EO
1'74038
'fi9 JAN 2 PN t: 0
~ . ~
~ ROG6~ PO~TRAS
~ CLERK CIRCUtT COURT
1 RJRTHER C'~RTIFY that I will comply with all ott~ nquinir~enb of a lepal residsnt of fhis Stat~.
1 FURTHER CHtTIFY that 1 have no intention to ~etum to my former domiGte, and 1 intend to remain in FORT -
PIERCE, SAINT WCIE COUNTY, FLORIDA, permanently. _
v
` (Name) Joan Keiser
~
(Addreu)
3~w~o~rn a and s~b~d befor• m. ~h~s 'lst ~r ~ January 19 69.
- . ~ ~ f.
~ . ~OOR ~OQRAi
C~CtNT ~011~T Notary Publk
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8y O.C. Mr Connnluion txpi~
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R~ M~e+rNd M~ a~ «i~M~i AMr will~ Cl~k CM~aN Gw~, au~ ~IieM~ wiM~ Taoc wiwrr,?
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y
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