HomeMy WebLinkAbout0247 I
~ectaratio~ ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
I
This is my declaration of Domicile and Citizenship in the State of Florida shat 1 am fiting this day in accordance and ~
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in conformity with Chapter 222, Section 222.17, Ftorida Statutes. ;
1 was formerly a(ega) resident of -_~~.4._~~w~le _ Georgia _
(City) (State)
and 1 resided at 10T Geor ia Avenue However 1 have changed my domicile
(Street and Number)
to and am a~d have been a bona fide reside~t of the State of Florida since APri l 1 T day of
~
, 193~, and 1 reside at 2008 Delanare Avenue +
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my detta~ation of citizenship, actual legal residence and domicite in the State of Florida.
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(Inse~t here any pertinent fads, such as sale of properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Eatering children in public school +
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Henry Floyd, 1[elvin Dou~a, Charlea ldichael Batten ~
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FIL-EO AND RECORDED
~.T. ~UCIE COUNTY. FLA.
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~9230
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4`~;~u ~'R~L'IT COURT
I FURTHER CERTIFY that I will oomply with alf other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT
,
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
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1/ 6~.. V1J-Q.. ~
(Name) gosa I,ee Batten ~
~
; (Address) ~
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..r~t~~':~~t_?~~ f-~`'~,i
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~•''S11~pct~ f~~rr?d suburibed before me this 20 . day of ~b~a~' ~ 19 70
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;o :'~x'• " ~t:•' •
- '~-c: . [~:-pO1TRaS
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" - iRCWT COURT Notary Public
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~ ~ D.C. My Commission expires
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(To bs executed i~ duplicate snd ori~inal fil~d with Cl~rlc Grwit Couet, snd dupliut~ with Tax Ass~s~or.)
800K 18 PACf ~ ~
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- No. 13
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