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Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. WCIE COUNTY, FLORIDA:
This is my declaration of Oomicite and Citizenship in the State of Florida that I am filing thia day in acoordanos and
in oo~formity with Chapter 222, Section 222.17, Florida Statutes.
i was iorr~ieily a iex~at res3dt~t of ~t=~~ N~ J•
(City) (State)
' and I resided at 346A CrOSa KOid . However I have changed my domidle
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Flo~ida since DeC. 22 day of
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_ , t9 and I reside at 451 ~x_ Naran ia Ave
. (Street and Number)
FORT PI~CE, SAINT LUCIE COUNTY, ROitIDA j
and this statement is to be taken as my dsclaration of citizenship, actual legal residence and domicile in the State of Horida. ~
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(Insert here any pertinent facts, such as sale of property or busineu, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Becoming a permanent reaident aad placing chiid in pnblic school
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(Char;ea G. Harris) ,
; FILEO AND RECOROED
• ST. LUCIE COUNTY. FL~.
REGO~18~;~V
'70 JAN 2 PM 0 S.
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; ~e~EQ f~017RAS
CLERK CIRCUIT COURT~
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~ 1 RJRTHER CERTIFY that 1 will aomply witfi all other ~equirement: of a le~al resident of this State. f
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1 FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~tl?~Qris~4Q~ ?/~:~.p !
~ Mame~ Arances B. Harria t
r, O~ Box 1117 Jenaeo Beach, Pla. ~
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(Address)
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~ s • = 2 Januar~ ?o
~~'~;$Niarn b anct wbscribed before me this day of , 19
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Sr:r'~"~~rwn~
: f1~11Q COURT Notary Public
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~ By D.C. My Commission expires
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~ Ro b~ ~x~eut~d in duptieat~ snd oriyinal Rlad with Cl~elc qreuM Cou~t, and dupliut~ wi~h Tax At~asor.)
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