HomeMy WebLinkAbout2518 Decla~ation ot Domicilf an~ Citiz~~ship ~~'~?'~6'7
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. LUCIE GOUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in ths State of Florida that 1 am fili~g this day in aooordanos and
in co~fwmity with ~hapter 222, Sectio~ 22Z.17, Florida Statutes.
I was forme~ly a legal ~esident of~lll~bua Georgia
(City) (Sta»)
2Z06 Nortb Lincola
and 1 resided at - . However 1 have charqsd my domidle
(Strest and Number) .
b a~d am and have been a bona fide resident of the Stats of Florida sinoe latb day of
April , ~q 69 ~ a~ ~ at 32Z~ Nostb llth atreet
(Strest and Number)
FORT M~CE, SAINT lUC1E COUNTY, RORIOA
and this stateme~t is to be taken as my declaration of citizenship, actval Icgal residence and domicile ~n fhe Stste of Fbrida.
(Insert here any periinent 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.)
Bntering Lindse~ Stubba in tbe 2nd grade
FILEO ANO RECORDEO.
ST. ~UCIE CQUNTY. FLA.
RE CO~~ VERIFtEO
1'7`~'06'7
'69 APR I7 A~{ 9: 36
~
! RO~EP, F'OtTRAS
~ CLERK CIRCUIT COURT
f
E
~ I RJRTHER CHtTIFY that I will comply with all other requlrements of a leqal resident of this Stats.
~
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT lUC1E COUNTY, FLORIDA, permanently.
:t~,~~;,:.,:;.
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. " ^ r~ fr~. ,
.
- ` _ ~ ~ • ! . :r ~ Aan Gr~ggeis ( ~Irs 1~ayMOOd )
_ , : _
~ ~ -
: ' _ - ' ~'b (A,ddress)
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• .,:~•:~V 1Ttb April 69
Swom b and subscribed before me this day of 19 •
. ~
ROGER rO1TRAS
CIRCt1R COURT Notary Public
By ~-G D.C. My Gommiss'an expiros
Re b~ ~x~c~hd ie duplicah sad e~i~iwal fil~d wilh Cl~k CM~f Coue~, and drpli~aN wi1M T~oc A~w~a
~~i~s
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