HomeMy WebLinkAbout1311 Deciaration ot Domi~ile and Citisenship ;
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNYY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Ftorida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Stroudsburg tenn
(City) (State)
R. D. 5
and I resided at _ However 1 have changed my domiqle
(Street and Numberj '
,
to and am and have been a bona fide resident of the State of Florida since J~• day of
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1
_ , 191~, and I reside at ~
(Street and Number)
FORT PIERCE. SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State c~ Flarida.
(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.)
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Entering child in public achool - Aancy~Watt$
FfLEO AND RECORDED
ST.-LUCt~ CQUNTY, FLA.
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'1Q J:1(~ 23 pM 2: 33
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~ ~LERK ClRCUtT COURT~
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~ 1 FURTHER CERTIFY that I wil) comply with al) other requirements of a lega) resident of this State. }
I FURTHER CERTIFY that 1 have no intention to return to my former domitile, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~g • (Name) At1II WSttB
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~ _ Sworn to aftd;subscribed before me this ~3 day of J8IIL18T~ , 19 70
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~ Roce~.~aam:as
Y~ CLFItK CIRCUIT COURT Notary Public
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By D.C. My Commission expires
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(To bs executed in dupliwN snd ori~inal filed with Cl~rk Grcuit Court, and dupli~ah with Tax Ass~ssor.)
N~. „ gooK1~2 PAbE1309
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