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~3ectaration of D©s~icii3 as~d Citizeln~~ip TO THE STATE AND COUNTY TAX ASSESSOR, S1. IUCIE COUNTY, FIORIDA: This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and in conformity with Chapter 222, Section 222.17, Florida Statutes. 1 was formerly a legal resident of Buena Park Cal. (City) (State) and 1 resided at 8261 San Helice Circle 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 Tuly 25 ~ day of 19_x, and 1 reside at 410 S. 25th Street (Street and Number) FORT PIERCE, SAINT LUG;i: COUNTY, FLORIDA 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.) Placing children in putlic school Ste~en~ Timothy, Tara Lynn Character FILED AND RECQRDED ST. IUCIE COUNTY. FLA. 182~'~'8 'S9 A'ID' 26 PM !2:24 pct°:~~ ~o~r CLARK C'RCUIT C URT 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. (Name) Patricia Character (~-ddress) Sworn to and subsuibed before me this 26th day of Aua us t , f q~Q_. • A `• ` ~ .• ~ •.- f ~. ROGER POiTi~S • .~ „: RK CIitG1lIT COt~ll'~ : ~ ": Notary Public _ ~ . _ , -. y ~ V _ gy S p.C. My Commission expires c~, . . (To be executod'in•duplicate and original filed with Ciorlt Cirwit Court, snd duplicate wi::s :ax t:..3.,.or.) BOOK ~~ PA~E~~~ ,•-•