HomeMy WebLinkAbout1350Declaration of Dolrniclle and Citlzanshlp
182092
TO THE STATE AND COUNTY TAX ASSESSOR,
S1. tUC1E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of ~Url_$~tOn Conn,
(City) (State)
and I resided at - Westaide B lyd. __. However 1 have changed my domidle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since a0th day of
Julys 19~i4, and 1 reside at 11A Snlsz ir.
(Street and Number)
FORT PIERCE, SAINT itUC1E COUNTY, FLORIVA
and this statement is to be 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.)
(School Children)
s~
Marq;-Anne - 2nd Grade FILED AND RECORDED
ST. LUCIE COUNTY. FLA.
:.Frt1RD ~'~RI~IEO
182092
'69 AUK 2I PM I : 46 ~'
YI. 6
iiOGEr~. ?017R
CLERK CIRCUIT C URT
1 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.
Mrs. Ds~~id Brh rdt
~~,r :,. (Name)
~• - •„•.
.: , - - ;-
`~% 110 Solaz Ave.
(Address)
,~ ',~` ~•~i~rQtir~sd and subscribed before me this 21 8t day of Au¢ust , iq~,Q_•
`- + - ''. ~
~'~ :I>lOOER POITRAS
CIRCUIT COURT Notary Public
~ -
By O.C. My Commission expires
(Te be exaarted in duplicate and original filed with Clerk CjrcuN Court, and duplicate with Tax Aswseor.)
-~. ,3 ~1~'9 ~~~49