HomeMy WebLinkAbout1758Declaration o! Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. tUCIE COUNTY, FLORIDA:
182.396
This is my d+aclaration 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 OrlsndA P In r ida
(City) (State)
and 1 resided at 4252 Old Do®inion Rd. _. 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 4th -day of
A»~u~ct__, 19~~, and I reside at 5b~n ~1MOl3t ~Yp.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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)
- FILED AND RECORDED
Richard Allan - 10th Grade ST• LUCIE COUNTY. FLA.
I? CDR[? V~'RIFlEQ
Valerie Ann - 9th Grade 182396
'69 AU6 2 9 AM 11:3 0
CLt_RK CIRCUI COURT
I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former
to remain in FORT
CIE COUNTY, FLORIDA, permanently.
PIERCE, SAINT W :!
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' ~'6t#I~q-.3~0`-- subscribed before me this ?ot h day of August , 19-b~--
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ROGER POITRAS
CIRCUR COURT
gy D.C.
Notary Public
My Commission expires