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HomeMy WebLinkAbout0592 Dacla~ation at Domicile a~d Citize~ship TO THE STATE AND COUNTY TAX ASSESSOR, ~~848 Sl. LUCIE COUNTY, FLORIDA: This is my detlaratio~ of Domicile and ~itizenship in the State of Florida that 1 am fiiin~ Mis day i~ aaoordanoe and in oo~formity with Chapter 222, Section 2Z2.17, Florida Statutes. I was formerly a legal resident of Csrtsb~d Ncr ~L~c±cn (City: (Stat~) and 1 resided at _?~~0 PlOridt Street _ . However 1 have chanqed my domitile (Street and Number) to and am and have been a bona fide resident of the State of Ftorida since -21id day of Ma~ ~ ~q 69~ and i ~eside at a006 33th Stteet (Street and Number) FORT Pl~t~, SAINT LUCIE COUNTY, RORI~A and this statement is to be taken as my declarotion of citizenship, actual legal residence and domicile in the State of Ho~ida. (Insert here any pe~tinent fatts, such as sale of property or busineu, or relinquishment of employment at fo~mer domicile, removal of family to new domicile, purchase of home, ett.) Bstsbliab residency to enter aepheM '•Stephea Mayae Da~is'• in the atb grade of school. His ~~t parenta ~+iil be co~ing soon snd ~rili be estsblishing reaidency also. F~lED AND REGORDED ST. ~UCIE COUNTY. FLa. ' ~.'~rla~~ ;~Er!^ir. r. j i~~ ~ S69 ~IpY 5 P~~i t I: N 9 ~ f V ~ ~ :):i..[ t"~~~::+.cJ ~ ~ ~L^~K ~:FLU~' COURT ~ R ~ 1 FURTHER ~ERTIFY that 1 will aomply with all other requiremenri of a(epal resident of fhis State. ~ I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT 4 PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. i ~ ~ , ~ (Name)NOt~al1 L4wreDCt ~ i ~ ~oo~ 35~` S~~ . ~ cAad~~:~ i ~ . ~ Sworn to and subscribed before ma this Stb day of ~y ~ ~q 69. ~ i . ~ itoocu ,r~quri~t~`:'.' q~ER1(~C~1?~~T Notary Public ~~~lT - ~ ~ By - D.C. My Commiuion expires _;J~?;= `l~y~~: •4c3_ ~ Qe b~ I M? •a~d oei~inal Rl~d wiN~ Cl~ic Cira~it Caret, and dup~eah wilb Tax A~o~.I ~_A!~i-~ S ~ . S9,t,. ~ ~ ~ so~ ~?7 ~acE ~ ~.<;s;,.,~- ~ _ ~ ' : _ ' _s - - ~ ~