HomeMy WebLinkAbout2343 18 : 3 ~E~
Declaration ot Domicile ar~d Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
I was fo~merly a legal ~esident of Fa~retteville N. C. ;
~C;ty) (State) ~
~
t
1505 Cameron Road ( Hope ?n11.18 Howeve? I have cha ed m domicile ;
and 1 resided at _ _ _ _ ^9 Y
~ (Street and Number) ;
to and am a~d have been a bona fide resident of the State of Florida since _.________-~Z~YL- _ day of ~
NnvPmbQr_ . 19~~, and I reside at ~~~~~.4Y~s Ft . F' _rea~~Fl~-
(Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida
(Insert here any perti~ent fads, such as sale of property or business, or relinquishment of employment z
at former domicile, removal of famity to new domicile, purchase of home, etc.) ~
~
1
3
c
i1-.ARY RUTH i+~ch;ILLAN
CI,ARII•1~. ELIZABETH ~rlciti~Ii,I,A21
FILED AP~D RECORDED? ~
G~,IZE LYi~d A~c~jILLA2t ST. LUCIE COUNTY. FLA: ~
- WII,LIA21 CA~SON t;c~II,LA13 R` r~R^ V~P.I~,ED ~
18`7356 ~
'6g DEC I ~ PM ~ : 56 ~
~ i
I ~~:=E_ R ~-o~TRa~ /
I CLERK CiRCU1T COURT~ ,
,
. ?
{
~
1 FURTHER ~ERTIFY that 1 will comply with a!I other requirements of a legal resident of this State. ~
_
~
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intenr! to remain in FORT ~
rICRt.L~ J/'Aiii~~T ~.v~i~ ~vLi~~TY~ F~v~iu~~ ~i:i~Tiu,iciuir. ~
~ GEIlE I,.ch:IZ,i,AIl..•~~~-:-,~ ~~~%/C-~~'~_
• • . - (Name)
~ Rt. ~4, Box 102, Ft. ~ierce, F1a. ~
. • ~ ~ ~ (Address)
' ~
, ~
5wo~n~to•and subscribed before me this 18th _ day of T~P~pmb~r , 19~_. %
ROGER POITRAS
CLERK CIRCU{T COURT Notary Public ~
gy c D.C. My ~ommission expires ~
t
(To b~ exscut~d in duplicats snd oripinal filed with Cl~rfc Circuit Court, and dupliut~ with Tax Ass~s~or.)
BooK 1~1 ~c~ 2343
~ r,o , 3 -
_
-
~ _ ~ _ _ _ . ~ _ _ ,