HomeMy WebLinkAbout2506Declaratlo~ of Domicile and Citizenship
X82922
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aooordanoe and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident ofC@d8r Lek@
and I resided et
Route 3, Bo= 4
(City)
(Street and Number)
Indiana
(State)
However I have changed my domidle
to and am and have been a bona fide resident of the State of Florida since Aug' 25
19-~, and I reside at
FORT PIERCE, SAINT itiUC1E COUNTY, RORIDA
811 Boston Avenue
day of
(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, a relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering daughter in public school (Theda Carol Alfrey)
Flt_EO ANO RECORDED
COUNTY. FLA.
,T. LU~eRC `1~RiF1E0
~~: ~ 152922
'g9 SEP ~ Z ~ ~ ~ ' ~ I
_ rn` _I
~C~`? , OIT COURT
CLERK CIRCUIT
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 domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name) Burnice Baric
-- - - (Address)
.-, .., _1 ~,~~ T-
~L~~~jtrrli; f .
~' *~,)•{,:and subscribed before me this ~ 2 day of Septemb@r , Tq~_.
-' 4- ' ~`~~q~~COURT Notary Public
;.
.~ D.C. My Commission expires
sy ~ '';
(To be oxocuhd in dupliuh and original filed with Clerk Cirwit Court, and duplicate with Tax Aaesaor.)
h{o. 13 ~~~ ~~~~
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