HomeMy WebLinkAbout0462 Declaration ot Domicfle a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and ~itizenship in the State of Florida that 1 am filing this day in acoordante and
~n co~formity with Chapter 222, Section 422.17, Flo~ida Statutes.
Crossville Tenn.
I was fo~merly a legal ~esident of
(City) (State)
and 1 resided at _ ROUte 6 Hcwever 1 have changed my domidle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~ce~ber 8 day of
, 19 70 , and I reside at 611-A SO. 17th Street
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residerxe and domicile in the Staro of Horida.
;
~
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employme~t '
~
at former domicile, removal of family to new domicile, purchase of home, ett.)
Placing child in public school - Debra l~iiarie ~ayes
FI~ED qN~
ST,FIU ~~~r UNTY. FIA. i
~~~~ED '
.l0 JAy 9 88106
I P~ 1:00 ~
' u%~."
~ f`Ur' 1 '~c`/
~ CLEi? '~r, r()t7R1;S
i K ~?RCU~T couRr
j i
s
i
[
~
f
; 1 RIRTHER G'ERTIFY that 1 will oomply with all other requirements of a lepal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIUA, permanently.
~
~ ~
~
~ (Name) Nell . Hayes ;
~
;
5 -
~C~f@S5~
; SyvqR7i
t¢and subsuibed before me this 9tb day of J~uary ~ 19 ~ 70 ;
- ~ . ~ _ ~
~ ' . ' _ ;
~ R4GER PG~TRAS
~ CL~C`C{~C COURT Notary Public
'r . ~
, ,
By ' , O.C. My Commission expires
~
~
~ (To uc~ait~d in duplicsf~ and oriyinsl fil~d whh CIKIc Cirsuit Court, and dupliut~ with Tax As~or.)
~ ,~.13 aooK1~2 PA6E 46Q i
~
_ -
3 _ ~
~a~,~ ~~~3~ .,,r. . ' . . ~ v...~~~~