HomeMy WebLinkAbout1342Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~~4
Sl. LUCIE COUNTY, FLORIDA: v+GV
This is my declaration of Domicile and Citizenship in the State ~of Florida that 1 am filing this day in aoaordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of I-~brriaon Tenn
(Ciy) (State)
and 1 resided at _ P O. Box 216 _. However 1 have changed my domicile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 1St day of
une Iq 69 , and I reside at 2010 Sunrise Blvd.
(Street aril Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Honda.
(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.)
(School Children)
Patrice Ann - 11 grade FILED AND RECORDED
ST, LUCIE COUNTY. FLA.
Vincent Daie - ?grade
'69 A,UC 2 ~p X84
M I : pe
~~
FGGf:r ~ OITR,Cg~
CLERK CIRCUIT COURT
I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to return-to my former domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
_r llamae LaMren
.~ _
- '.~ J 1 ,•'`f,_ (Name)
~; ~ -
._, ,~ ~ 2D10 S~nr± se Hlyd.
- (Address)
• 4J~
•,; • • • rnstp~,~s[>~svl~cribed before me this ~t e+ day of • •+ s+• ~ + - 19_x¢.
ROdER PORRAS
CLERK CIRCUR COURT
By D.C.
Notary Public
My Commission expires
(To be executed in duplicate and original filed with Cleric Circuit Court, and dupliuta with Tax Atee:.a.)
tie. 13
a~K1'~J M~1341
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