HomeMy WebLinkAbout0927 Decla~ation ot Domicile and Citlsen~hip
F
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Si, IUCIE COUNTY, FlORIOA: `
This i: my declaration of Oomicile and Citizenship in ths State of Florida that 1~m filiny thi• day in aooords~os and
in oonformity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was fo~meriy s leqsl ~esident of Yuma Arizona
(~~~y) (Staro)
1186 West ~ings Laae !
and 1 resided et Howevsr I have cha~ged my domic3le ;
(St~oet and Numbe~) ;
to and am and have been a bor~a ftds ~esident of the Staro of Florida sinas January 3 dey of
, 19 70 , amd I r~ide at 520-B Hoily Ave.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to bs takan as my declaratio~ of citizenship, actual legal residenoe and domicile in the State of Flotida.
(Insert here any pe~tinent facts, such a: sale of property or business, or relinquishment of employment ;
at former domicile, renwval of family to new domicile, purchase of home, etc.)
Placing cdildren in public school - Scott and Brian Bates
Np RECOR~~D.
FIl.EO A ~pUNTY. Fl.~' - ,
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~ ~LERK CIR~~~T RT:
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~ 1 FURTHER CERTIFY thst i will oompiy wlth all other requirements of a(eyal resid~nt of this State.
I FURTHER CERTIFY that I have no intention to ~etum to my former domiGle, and i intend to remain in FORT
PIERCE, SAIN7 LUCtE COUNTY, FIORI~A, permanently.
? ~ a~~ ~ ~ 1~.9.. ~ _ _ i
~ (Ne~) Beneta Bates ~
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~ ' 19 Januarq 14 ~o , l
~ 5wom to and :ubscribed before me.thi: day of , .
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~ ROlsER'`PQ,~i'AS
~ ,_.~-C4ERK CIRCUIT COURT Notary Pubik
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' By ' D.C. My Gommission expi~es
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~ (Te b~ ~x~cvt+d in dupGut~ snd ori~inal fil~d with Ct~irk q~wi1 Court, and duplicat~ wjtb Tax Asa~ssora
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~ 800K ~O~ PACE ~7z5
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