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Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordanoa and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Wilmington
(City)
and 1 resided of
32 Georgetown Ave.
(Street and Number)
Delaware
(State)
However 1 have dtianged my domidle
to and am and have been a bona fide resident of the State of Florida since Aug. 21 day of
19 69 , and I reside at
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
9~it>11x 3013 So. 4th Street
(Street and Number)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Shelia and Loretta Prashure (entering children in public school)
,~T~ C~~ E CO fC~ROED
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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.
(Name) Helen Prashure
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- ~t~~~tAsnd,s}~~sdcribed before me this 3 day of SeAtember ~ Iq 69
R~OC~It:~FOi'[k~s
SIG - COVE Notary Public
gy i'"" D.C. My Commission expires
(To Ite executed in duplicate and original filed with Cleric CitYUit Court, and duplicate whit Tax Atseseor.)
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