HomeMy WebLinkAbout2738 Declaration ot Don~icile and Citise~ship ;
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordanos and
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in confo~miy with CFiapter 222, Section 222.17, Floricls Statutes. ~
I was formerly a legal resident of Ze~@ A~BtCOI'lg New Jersey.
(C~tY) (Stats)
and I resided at BO]C 4 3 R. D. #1 . However 1 have changed my domicJle
(Strset and Number)
to and am and have been a bona fide resident of the State of Florida since January 10 day of
_ ,~9
6~, arid I reside at 2729 South Federal Hi~hway
(St~eet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be take~ as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or rtlinquishment of employment
at former domicile, removal of family to ~ew domicile, purthase of home, etc.)
Establishing residency and placing child in school
Pamela Moore
ST. L C E COUN
TY, FLed:
. RF.CORD VFRI~IED
, 1~'S~27'
~ '69 FE6 2~. A~I 8: 4 9
I ^ F ;i~
~a~_R ~~oit~As
CLERK ClRCUIT COURT~
I FURTHER CERTIFY that ! will aomply with al) other requirements of a Ispal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domicile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) s . Henry G . Moore
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~ ~ ~ (Address)
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~ Sworn to aod subscribed before me this 24 day of Februery , 1969
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~ ROO~R rO~T~Af =
~p(- COIiRT Notary Public
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By i~ x~- D.C. My Commiuion expires {
` , .
- (T~ w~ac~c~hd ie duplicah and e~ioinal fil~d wilh Cl~k qn~it Care~, snd dupNcaN wi11~ Tax As~~.) '
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