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HomeMy WebLinkAbout1723Declaration of Domicile and Citizenship TO THE STATE AND COUNTY TAX ASSESSOR, 18265 Sj. IUCIE COUNTY, FLORIDA: This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordancs and in conformity with Chapter 222, Section 222.17, Florida Statutes. 1 was formerly a legal resident of Camden and I resided at 352 Monroe S treet (City) (Street and Number) However I have changed my domicile to and am and have been a bona fide resident of the State of Florida since Aug• 21 day of 19~~, and 1 reside at FORT MERLE, SAINT LUCIE COUNTY, RORIDA 5701 Oleander Blvd. (Street and Number) 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 busineu, or relinquishment of employment at former domicile, removal of family to new domicile, purchase of home, etc.) Placing children in school Brendan Stan, Jr• Doana and Joy Cunninghallt ~ ~~ to ~ N s7 ~-q ~ ~3 CC rn r~ iq ~Q nA© (7 t?? N ~ m 2 ~~ °° o~v co ~ <c~ ~ --i ~I Z ~ n~ ~"{O n N CN .. rn'• d ~~ w D I FURTHER CERTIFY that 1 will comply with all other requiremenri of a legal resident of this State. I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. (Name}llice Cu Ingham (Address) fir. "... ~' . . ,,~, . S+Narn to and.wbsaibed before me this 28 day of ~ ~'uSt ~ Iq 69_ ._ • _ ti • - ~~~~_ `~ CR4E~C .~TR~cc'~uRT Notary Public y ~1;~ y MC I gy D.C. My Commission expires ~r ,.. (Te be executed in duplicate and original filed with Clerk Cirwit Court, and duplicate with Tax Assaaor.) 600K~'~~ 1~1'1~1 No. 13 .- .. - - - Ar$aI158s (Ststa) i^