HomeMy WebLinkAbout2757 Decla~ation ot Domicile and Citizenship
TO THE STATE AND GQUNTY TAX ASSESSOR, ~
Si. WCIE COUNTY, FIOR~ur~:
This is my declaration of Opmicile and Citizenship in the State of Flo~ida that 1 am filing this day in aaoordanos and
in oonformity with Chapter 222, Sectior~ 222.17, Florida Statutes.
I was fo~merly a legal resident of ~DO~t N~ C~
(Ciy) (Stet~e)
and I rosidad et p• e~
. However I have chanyed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Flo~ida sinc8 Aplil ."ZO day of !
- ,~969 , and ~ ~eside at 611-B South 17th Street
(S~eet and Number)
FORT MERCE, SA1NT LUCIE COUNTY, RORtDA
and this statement is to be take~ as my declaration of citizenship, actual legal residenea and domicile in ths State of Horids.
(Insert here any pe~tinent facts, such as sale of p~operty or busineu, or relinquiahment of employment
at forme~ domicile, removal of family to new domicile, purchase af home, etc.)
placing child in public school
RiC~q Lee Jones ~~tL
C E~C UN TY,DFIA.
E=C.•':^r~ yc~1~f~D
1'7`~'244
. 's9 pP~ 22 aa~ 8: s2
etQ~:~: F ~~ptTR
CL~RK CiRCU1T COURT
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1 FURTHER CERTIFY that 1 will oomply with all other requirements of a le~al rasident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and ! intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
.
, (Name) s . 8ssie Jooes
(Address)
Sworn to and subscr~~.befare me this 22od day of April , ~q 69 '
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RO~i6~,~
•,~~AS .
~ ~ Notary Public
_ _
BY D.C. My Commiuion expires ~
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