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HomeMy WebLinkAbout2844Declaration of Domicile and Citisenship TO THE STATE AND COUNTY TAx ASSESSOR, 183181 S~. LUCIE COUNTY, FLORIDA: This is my declaration of Domicile and Citizenship in the State of Florida that 1 sm filing this day in aooordanoa and in conformity with Chapter 222, Ssdion 222.17, Florida Statutes. I was formerly a legal resident of 4hvi11 _ Ner*h ra,~liaa (city) (Stab) and I resided at 652 Pairview Rd. However I have changed my domicile (Street and Number) to and am and have been a bons fide resident of the State of Florida since ~~ +h -day of Yeen September Iq 69 , and I reside at Rt 2 B 1 4 R (Street and Number) FORT NQCE, SAINT LUCIE COUNTY, FLORIDA and this statement is to be taken as my declaration of citi2enship, actual legal residence and domidle in the Stab of Honda. (insert here any pertinent facts, such as sale of property or business, a relinquishment of employment st former domicile, removal of family to new domicile, pundtase of home, etc.) (School Children FLIED ANp RECDRDEp~ ST. LUC-E ~pU Charles 8dward - 10th Grade l~F'C017p ~ERt~~pf''~•' Robert Purser - 8th Grade X69 SEP +8 83181 Mary Jane - 7th Grade ~. ~ I ~ Oy h '/~\~~ nQ~ER POIi'RAS John Raymond - 6th .Grade ~t_EftK CIRCUIT C©tJRT. r -- I FURTHER CEitTIFY that 1 will comply with all other requirements of s legal resident of this Stab. i FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. _,~: ,-... 1~lrs. C. B. dersoa ,- • ~j~'~ :,''~'~:~ (Name) • ._ _ ~`•- . ~ ~- Keen ,; ~ _ - ~ - (Address) "-' - • --: .:~ - ~C%.~ ~.Sworrr•~t3 and subscribed before me this 18th day of September , tq 69 , :~,., ~,. ROGER PORRAS CLERK CiRCUR COURT gy D.C. Notary Public My Commiss'~on expires (To be executed in duplicate and original filed with Cleric Circuit Court, snd dupficab wiNr Tax A~eora 600K~?9 ~2 No. 13 ~. =}~ N. _~ _ . _ _._