HomeMy WebLinkAbout1544 ~ Declaratton of Domiciie a~d Citi:~saship
1844~0
TO THE STATE ANO COUNTY TAX ASSESSOR,
Si. LUCIE COUNTY, FLORIDA:
This is my daclaration of Domicile and Citizenship in the State of Florida that i am filin~ thls day in sooordanos and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal ~esident of~Co~as Weat Virginia
(Cify) _ (Stah)
and I reaided at BOX a86 . Howevar 1 have chsrgsd my domkile
; (St~eet and Number) -
to and sm and have been a bona fide resident of the State of Florida sinoe 13~~ day of
October , ~q 69~ i at 30 S Znd Stseet
(Street and Number)
fORT M~CE, SAINT LUCIE C01iNTY, lLOItIDA
and this statement is to be taken as my detlaration of citizenship, actual legal residenoe and domidle in ihe Sta/e of Horida.
(Insert here any pertinent facts, such as sale of property or business, or telinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) '
- Bntering Bonnie in the ist grade
FlI,ED A~lO RECOROEO ~
ST, ~UCIE COUNTY, FLQ.
f?=.C~?G 1~ERIFIED
184450
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I FURTHER CEitTiFY that 1 wiil aompiy with all other rsqutrements of a le~al resident of this Stafe.
1 FURTHER CERTIFY that I have ~o intention to retum to my forme~ domicj;e, and I intend to remein in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy.
. 1
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' - Basbasa Hsrvey ( Mra Darrell )
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~Swpf~to~e~d'svbsuibed before me this 20 ~y of OCtObes 19 .
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ROGER POITRAS
CIRCUR URT Notary Pubiic
(DOz~i~,G~i
6y c~~ D.C. My Gommiuwn expires
~Te b~ uc~wt~d in duplicaN and ori~inal fi{~d wilh CM~Ic C~rarlt Cou~f, and duplicat~ wilh Tax At~ora
,3 aooK180 ~15~ _ .
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