HomeMy WebLinkAbout1399 Declaration ot Domicile and Citizenship
TO tHE STATE AND COUNTY TAX ASSESSOR,
51. lUClE COUNTY, FLORlDA:
This is my dectaration of Domicile and Citizenship in the State of Florida that I am filing this day in aaordance and
~n conformiry with Chapter 222, Section 222.17, Florida Statutes.
Grand Rapids Michigan ~
i was formerly a legal resident of _ _
(City) (State)
and I resided at ~~~~~x ~ 65~ Royel Oaks, S.~f. Wyoming, Michigsn
However 1 have changed my domic.ile !
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _ NOVeIDber 15 day of
_ , ~9Sz~, and I reside at 0. Drawer 1088 Ft Pieree,Fla
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, aduai legat residence and domicite in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or refinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Placing child in public school - Lori Robb ~
F11.E~ ANp RECOR~~
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RFC~RD ~ ,
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185~' c 5 p~ ~'1' ~
+69 DEC ~
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I FURTHER CERTIFY that I wil( compiy with all other requirements of a iegal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domiti~e, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
? ~
, (Name) Bo212ife Ro
k
, . . (Address) ~
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~~Sworn to and subscribed before me this day of c- _ ~q~,
,
ROGER~ PdifRAS
CIRC~ COURT Notary Public
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BY D.C. My Commission expires
Ro bs sxscuted in duplicats and ori~inal filed with Werk Grcuit Court, and duplicat~ with Tan Ass~s~o?.) '
dooK i~1 ~?~E13~9
No. 19 •
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