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Decl~sration ot Domicile and Citizenship
180884
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA: ±
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This is my declaration of Domicile and Citizenship in the State of Fiorida that 1 am filing this day in aaorda~ce end ~
in co~formity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal reside~t of _ Asb~ll! _NOtth CaIO~l~i ~
(City) (State) ~
32 Be~erleq Road `
and 1 resided at - However I have changed my domicjle ~
(St~eet and Number) ~
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to and am and have been a bona fide reside~t of the State of Florida since lst day oi ~
Jn19_____ _ ,~9
68 and I ~es~de at D~ M lrbbilt Ho~re Court , Jensen Bc, Pla. ~
(Streat and Number)
FORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, act~al legal residence and domitile in the Stab of Horida. ~
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residenceq
FILEO AND RECOROED'
ST. LUCIE COUNTY. FLA. •
RE C4Rn VERtFIEO
180884
'69 Jtll 22 PN ~ : 0
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RpGER. FOiTRAS
CLERK CIRCUIT COURT~
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a le9al resident of thi: State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domitile, and 1 intend to remain in FORT
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~ ~?~N~•LUCIE COUNTY, FLORIDA, permanentl
~ PIERCE, y.
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S ~ • . . `,~t _ 7t Gt. Q (
~ _ ' _ ' _ . . " ~l (Name)
, - - - Linda Arnett
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" . . ~v (Address) - -
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~ Sworn to and subsuibed before me this 2~ day of Jnly ~ ~q69
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~ ROGER rOITRAS - -
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; CIRCU~ COURT Notary P~blic
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By D.C. My Commission expires
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~ (Te r..s«rt~d in duplic.~..nd o~i~inal tiNd wi1i~ a~k c~ c.o~.+. .~d d~plica~. wiN~ Ta~c A.......a
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