HomeMy WebLinkAbout2484Declaration of Do~nlcile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl, lUC1E COUNTY, FIORIDA:
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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.
Anchorage Alssks
1 was formerly a legal resident of ~;~;~~~
Adel (City)
Georgi>s(sta»)
and 1 resided at _ 7411 Stanleq Drive _ However I have changed my domiale
204 B. Pirat Stree (Street and Number)
ro and am and have been a bona fide resident of the Sta» of Florida since 1St day of
July , 19 69 and 1 reside at Hoily Rd. St. Lucie Rimier -P.O. Box
(Street and Number) 802
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Sta» of Florida.
pnsert 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.)
PLAITING CHILDIRBN IN SC)i00L
Psui Vining _i? qrs. RECORDE~
D pND FLr-
Tio Vining 14 yrs. S ~~~ C~ ~ ouN ~F ~ ~~?
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this Sta».
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.
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(Name) ~ yD in Dg
P.O.Boa 802, Ft. Pierce, Pla.
(Address)
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•~ _6~1~• ~~•~'~it1d sukt;uibed before me this 12th day of SeDtetaber , 19 69.
ROGER POITRAS
CLERIC CIRC~Ij COURT Notary Public
gy ///G~1,1 ~ / ~i1 D.C. My Commission expires
(To be executed in dupliu» and original filed wHh Cleric Circuit Court, and dupliu» with Tax Aaaaor.)
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a~K179 ~~E2482
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