HomeMy WebLinkAbout1309 Deciaration ot Domicile and Cttisenshtp
TO THE STATE AND COUNTY TAX ASSESSOR, ~ov ~
Sl . lUC1E COUNTY, F! ORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordan~ and
in conformiry with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Sh61by Oh10
(Ciy) (State)
and I resided at 32_ Osk _ StI'eet ~Wever 1 have changed my domicrile
(Strest and Number)
to and am and have been a bona fide resident of the State of Florida since _ 9th day of
_ _ Januar~?__ ~9?0 , and 1 res~de at 408 North 39th street _ ~
- 1
_ (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, aOR10A
a~d this statement is to be taken as my declaration of citizenship, adual legal ~eside~ce and domicile in the State of Horida. ~
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(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.) '
Entering children in school
FILED ,sND RECORDED
~UCrE r.OUNTY, FL:;.
..f:~'lc,•~ ~rc.~;~ -
7 18$`7g ,
' ~ 23 p~t~ 2: 03 ~
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_ ='~{CJl~T,COURT
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~ 1 FURTHER CERTIFY that I will com I with al) other r uirementa of a 1 al resident of this State.
P Y eq ~fl
I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
PIERCEtLSMAINtirl~l,Ct~ COUNTY, FLORIDA, permanently.
~ _ .1~- - .
~ _ ~ : ~ (Name)
~ ' - - _ Peggy .H~ Harry
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~ . . (Address)
4: 'r
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~ 23r.d January 70
~ Sworn to and subscribed before me this day of , 19 . F
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~ ROGER POITRAS - ~
~ K CIRCUIT COURT Notary Public }
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~ 6y `z~~~ D.C. My Commission expires
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~ (To b~ ~xscuted in dupliute snd ori~inal Rl~d with Cbrlc Grcuit Court, and dupliut~ with Tr~x Ass~ssor.)
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~ g~~182 FA~E1307
~ No. 13 . _
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