HomeMy WebLinkAbout1553 ~la~ation ot Domicile and Citizenshlp
18445'~
Tp THE STATE AND COUNTY TAX~ ASSESSOR,
51. lUC1E COUNTY, FIORiDA: .
_ This is my declaratio~ of Oomicile and Citize~ship jn the ~tate of Florida thst I am filin~ this day in acoordanos and
in oonformity with Chapter 222, Sectio~ 222.17, Florida Statutes.
1 was formerly a legal resident of . HO,~k~~tOn _ 1?d~=-
(~ity) (Sta1~e)
and I resided at 66 ~bin StteQt , However I have chan~ed my domi~3le
(Street and Number)
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to and am and have been a bona fide ~esident of tha State of Florida since 17th day of
October , 19 69 a~ ar 1104 Bos~o .A~e.
_ (Strset snd Number)
FORT r1~tCE, SAINT LUCIE COUNTY, RORIDA
and this sfatement is to be taken as my declaration of citizenship, actual legal residenoe and domicile in the Staie of Horids.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of hoR~e, etc.)
Doreen ~on Daaon l0 qeasa of ase
~7'L~U~ ~ND RFCOROEp
Sebra I~arie Daaon 8 ytass of age „ LQUNTY, F~,~,
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Da~+n Bilen Daaon 6 yesrs of sge
'~9 ^^t 20 At~ I t: S6
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CLERK ~1RCJIT COURT
Bntering Cbildsen in Scbooi. .
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I FURTHER CHtTIFY that 1 will aomply wHh al) otF~er requlrements of a Ispal ~eiidant of thit Stste.
I FURTHER CERTIFY that I have no intention to returre to my furmer domitile, and I intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
DOrTAID B • D~l11~1 .
(Name)
~t,,. 1104 Hoston A~t., Pt. Pierce, Pia.
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j: (Address)
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' ~ ~ . - th Octobes 69.
;~i~orn to atjy~:lGl~aibed before me this day of , 19
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~"CQ1~T Notary Pubiic
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By p'-- D.C. My Commiuion expites
(To b~ ~nouhd in duplkab aed oriyinal 81~d wilh Cl~ek qra~if Coir~l, aed dvpfiea~a wilh Tax As~ora
~~1~ ~~5~i0
Pto. 13 _ .
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