HomeMy WebLinkAbout0092 ~Declaration ot Oomicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUt'JTY, FLORI~A:
This is my declaration of ~omicile and Citizenship in the State of Florida that I am filing this day in actordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
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Rossville Georgie
1 was formerly a legal resident of -
~~;~y~ (State)
t
4~4 Evans Road
and 1 resided at However I have changed my domiC+le
(Street and Number) „
to and am and have been a bona fide reside~t of the State of Florida s~~ce _ December day of
211 1 2 N 1 th e
_ - -
(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 Florida.
(Insert here any pertinent facis, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) .
Placina~ son in public school ~xax(James Edward German)
FtLEO AND RECORD~ D
ST, LUC1~ i,0U1'~TY~C .
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f CLE~K CtR~';~T COURT
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~
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~ I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) Ofer verman
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_ Sworn to and subscribed before me this ~th day of January ~ 19 70
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~ ~ ROGER • P01TR~?S.
~ . ~LERK CtRWl1 _COURT Notary Public
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By ' , U.C. My Commission expires
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~ (Tai b~ ~~t~_ in`dupliuts and original ~iled with Cleric Cinuit Court, and duplicate with Tax Asseswr.) t
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BOOi(~~~r PAC~ e~
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