HomeMy WebLinkAbout2212 1'74695
Declaration ot Don~icile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIdRIDA:
This is my declaration of Oomicile and Ctizenship in the State of Flo~ida that I am filing this day in acoordanos and
in co~formity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of H artsviile SO Carolina
(City) (StaM)
and 1 ~esided at _ Rt 2 Wi113s Drive . 1io",~ever I have changed my domicile
(Street and Number)
ro and am and have been a bona fide resident of the Stab of Florida sinoe 7th dsy of
jebruary 69 Shaffner Motel(Temporary)
_ , 19 , and 1 reside at
(Street and Number)
~OltT PIERCE, SAINT tUC1E COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domitile in the State of Florida.
(Insert here any peNinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Sstablishing residence
~ntering Dixie Lee Shipman
James Rodney both in Dan McCarty High School
FIlEO AND RECORDED'
ST. LUCIE COUNTY. FL~L
Be~Eyl Lynn in ?th grade ~c_~Og~,~~~~~
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'~9 FEB I 2 A~I g; p2
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OGc~c
CLERK CIRCUIT COURT~ ~
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I FURTHER GERTIFY that I will comply with all other ~equirements of a le~el resident of this StatQ.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINJ!LU~t~ 60UNTY, FIORIDA, permane~tly.
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~ ' ~'%r- ~ Tennessee 6hipman ( Mrs James )
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; ~~w~Otn~to and subscribed before me this 12th day of Februarv , ~q 69, ~
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ROGER POITRAS
CIRCUII COURT Notary Public
gy D.C. My Commiuion expires
(To b~ ~x~aM~d in duplicat~ ~nd oripi~al fil~d whh CIKIc qra~if Couet, and duplicat~ wilh Tax AsNS~or.)
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