HomeMy WebLinkAbout0601 DeclaraUon ot Domicile and Citisenship
TO THE STATE AN~ COUNTY TAX ASSESSOR, 1"756'79
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in ths State of Florida that 1 am filin~ thit dsy in aooordanos and
in oonformity with Chapte~ 222, Sectio~ 222:17, Florida Statutes.
I was forme~ly a legal resident of E88t I,eke Ohio
Kity) (State)
and 1 residad at _ lOf>4 CeDte~c' Roed ~WeV~ my ~~1e
(Streat and Numbe~)
to and am and have been a bona fide resident of the State of Florida sinoe Mar .h 12 day of
, 19 69 , and 1 reside at 3506 Avenue 0
- (Sfireet and Numbef)
~ORT PI~CE, SAINT LUCIE COUNTY, RORIDA
and fhis statement is to be taken as my declaration of citizenship, adual lagal residenoe and domicile tn the Stab of Horida.
pnsert he~e any pertinent facts, such as sale of p~operty or business, or relir?~uishment of employment
at former domicile, removal of family to new domicile, purchase of hame, etc.)
Placing children in school -~ead.lynn Foa
cea
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~ I FURTHER CERTIFY that 1 will comply with all other raquirement~ of a le~al rosidant of this
8ttate.
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I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and i intend to remain in FORT
PIERCE, SAINT LUCtE COUNTIf, FLORIDA, permanently.
(Na Aancy Bennett ~
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t-tota~d subscribed before me this 17 da of ~eTCh , 19 69 .
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' . ~~~RCIq1' COURT Notary Public
~ By D.C. My C.ommission expires
(T. b. .x«w~d in d~plic.~. .MI o~i~inal tif~d wil1~ u«k ciro~b c.aret, .nd drplicat. wi11~ T.s A...MO.a
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