HomeMy WebLinkAbout0927Declalration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
S1. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in so~ordance artd
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of
Shama
(City)
and 1 resided at . P' ~• BOZ 37S
(Street and Number).
to and am and have been a bona fide resident of the State of Florida since
Wisconsin
(State)
However 1 have changed my domidle
June St iS
69 Route 2, Bo: 2465
19 -, and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
day of
and this statement is to Ise taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Placing children in public achooi
Michael h Dlaxine tu7fcendall
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return_to my former domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~' ~ ._;;`- ~ '~ a .`:~- "? _
• ~ `Syrocn~.and;ybsoribed before me this
~ .t2~y
(Name)s er G. ICuykendali
(Addf@SS)
13
~IEQI[hCYR COURT
gy Y ` ~ ~'~t D.C.
My Commission expires
(To he executed in dupliuto and original filed wish Clerk Cirwit Court, and duplicate with Tax Aaesror.)
aooK ~79 ~~ 926
tJo. i 3
day of AuBuat ~ Iq 69 .
Notary Public