HomeMy WebLinkAbout1142 Declaration of Domicile and Citizenship
,
TO THE STATE AN~ COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that I am filing this day in aao~dance and
in conformity with Chapter 222, Section 222.17, Florida Statutes. -
I was forme~ly a legal resident of Potesu Ok1ihOIDi
Kiy) (State)
and 1 resided at _ GCt1. Dt1i~IeIY _ However 1 have changed my domiule
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 19th day of
_ ____~anuit9 , 19
T~ , and 1 reside at a604 POIDpOt10
(Street a~d 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 fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Schooi Children)
Gary Dean - 6th Grade
Brian Keith - 3rd Grade FILED AND RECOROED~
ST. LUCIE COUNTY; ~LA.
Rf:COR~ V~RIrIED
18864~
~ ~'70 JQN 2 I A~I I I: 3 9
~
! „ : N -.OITR;,~~~ ~ ~
F ~ V . ' S
~ CLERK CIRCUIT COURTi
1 RJRTHER GERTIFY that I wil) oomply with all other requirements of a leyal resident of thia State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
Mildred A. Scribner
~
. r~., a. Q. u _
~
(Name)
,..,•,:•J,,r
. , ~~:i
~ ~ ~ ° ~ ^ % 26U4 PO~pono Ct.
5. li r~.
~ ~ : - ~
r~ (Address)
~ ~
~ , ~ -
Sworn to~~d~ubscribed before me this 21st day of J~nL~r~ , 19~_.
` ' ' :
- -
. '.~t
, -
.
~ ~kos~l: ~omu?s
~ RCUIT CO RT Notary Public
B D.C. My Commission expires
Y
(To b~ ~xecuhd in dupliate and oripinal Bl~d with Cl~rlc Grarit Court, and dupliut~ with Tax Ass~ssor.)
~ ° R 182 1
' ~ BOOK PAGf ~~U
No. 13
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