HomeMy WebLinkAbout1433 Decla~atio~ ot Domi~iie and Citizenshi~
TO THE STATE A.NQ COUNTY TAX ASSESSOR,
Sj. lUC1E COUNTY, FLORIDA:
This is my decla~ation of Domi=ile and Citizenship in the State of Florida that 1 am filing this day in acoordanoe and
in conformity with Chapte~ 222, Section 222.17, Florids Statutes.
I was formerly a legal resident of ~i~lton-3alA~ g. C.
(Ciry) (Sta»)
and 1 fesided et $onte 10 , Howevsr i have chupsd my domkile
(Street and Numbe~)
ro and am and have been a bona fick resident of the Stste of Florida sinoe Ootobe7c 15 ~y
, 191.~, and I reside as 105 Ao. 39th 3t7~eet
(Street and Numt,sr)
FORT MERCE, SAINT LUCIE COUNTY, ~LORIDA
and this statement is to be taken as my declaration of citi2enship, actual legal residence and domicile in the Stab of Horida.
(Insert here any pe~tinent fscts, such as sale of property or business, or ~elinquishment of amployme~t
at fomner domicile, removai of family to new domidle, purchase of home, ett.)
Placing ohildren in publio eahool: lCi~ty, geith and l[yra 'Pnlbert
F?`E~ ANp RE~DY~~I.A, .
ST. 4W C~ ~OV R1F+ED
_ 1~~'~ ~ 0
2~
. ,69 ~~1 16 P~l
~~~!~E-~ r•Uj~R~S ,S
t;.. s COUR
Cl.ERK ~1RCVIT
[
I RJRTHER CERTIFY that f will oomply with all oti~er ~equiremen~ of a le~sl residsnt of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remsin in FORT
PIERCE, SAINT LUCfE COUNTY, FLORIDA, permanently.
~
e) ganoy Tnlbert
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~ ~~~ribed before me this ~y of Oo~.ober - 19 69
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~~C~UIT COtlRT Notary Public
By ~ C D.C. My Commiuion expires
(Te Iw sn~wNd in d~rplical~ and ori~inai ffNd wilh Cl~ek P~f~~~~~d d~Na~ w~b Taoc Aaaso~a
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