HomeMy WebLinkAbout0097 DeClaration ot Domicile and Citisenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. LUCIE COUNTY, FIORIDA: '
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This is my declaration of Domiuie and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
Lo an West Virginia ~
I was forme~ly a legal resident of - - ~
~C;ty) (State) ~
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and I resided at ___B~?~_ ~_9~ _we8t I,Ogan Howev~r 1 have changed my domitile
(Street and Number) December
to and am and have been a bona fide resident of the State of Florida since ~ 3 day of
_ 19~g-, and I reside at -_.~Q$ ~1
-Ss4...t r~ pn nrive
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FORT PIERCE, SAINT IUCIE COUNTIf, FLORIDA
and this statement is to be taken as my cieclaration of citizenship, actual lega) residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
Placing child in public school - Joey Lucas ~
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FILED aND RECORDEO ~
Si. LUCIE COUNTY. FLA.
.=C:?~:' `IF?I~~~~ ,
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'70 J~t~ 5 ~?1 9 ~ 7 =
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•::':-•E =OI~Tr.~S
k CLERK C+RCUIT COURT~
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I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State. ~
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I FURTHER CERTIFY that 1 have no intention to return to my former domiCile, and I intend to remain in FORT ~
PIERCE, SAINT ttiClE COUNTY, FLORIDA, permanently. ~
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ame) JOe LLiCBS g
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(Address)
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~ Svuorn,to ar~ subscribed before me this 5th day of January ~ ~q ?0 §
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~ - ROGER POITRAS }
~ . - CLERK CIRCUIT tOURT Notary Public ~
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~ gy : D.C. My Commission expires
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~-R (To b~ ~xecuted ~n dupl~ate snd original filed witl~ Clerk Grwit Court, and duplicsts with Tax Ass~s~.) !
~ BOOK182 ~,~E 97
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