HomeMy WebLinkAbout1579 Declaration ot Darnicile and Citisenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~88~3Z
Sl. IUCIE COUNTY, FLORIDA:
This is m~ ~eclaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and
im m~formity with Chapter 22?, Settion 222.17, Floride Statutes.
I was formerly a(egal res~denr of _ Salem . 8ew dersey _
(Ciry) (State)
and 1 resided at _ 38 S@V@IIth 8t2'e@t However I have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 26~_ day of
January_ ,~q 70 , ano t f~si~e ar C. Tarilor Park
. (Sireet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actval legal residence and domicile in the State of Ho~ida.
(Insert hare 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 Terry and Carol in Scnool
FILED A(VD R~CORDEp~
ST. LUCIE COUNTY. FLA.
nE:CQR^ :~ER;~sED
~.8$93?
_ 'l0 JAN 28 P!~ Z: 5~
~,_e~~E?= ,o~T~~s
CL~RK ClRCUIT COURT'
I FURTHER CERTIFY that I will aomply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SANUT'LUt1~,:~0UNTY, FLORIDA, permanently.
. : ~ . '
. ~ ' . , . • /
. - ~ ~ -
- ~ ~ ' ~ • _ - (Name)
~ . = Mariqn i~:
_ ~ - . _ . a~[a~ Henderson ( Mrs Rolan
~'r' • , - . (Address)
,
, ' . .
, . ~ ~
Swom to and suburibed before me this 28th day of January ~ ~q_~Q
ROGER POITRAS
K CIRCUIT COURT " Notary Public
By °"''E`"E D.C. My ~ummission expires ~
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(To be sxecuted in duplicsh and oriqinal fil~d with Clerk Urcuit Cour~, and dupliuh with Tax Assestor.)
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