HomeMy WebLinkAbout1384 ~eclaration ot Dornicile and Citize~ship ~
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TO THE STATE ANO COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA: 1931J~7
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in aooordanoe and
~n conformity with Chapter 222, Settion 222.17, Florids Statutes.
1 was formerly a legal ~esident of North Baltimore Ohie
(City) (State)
and I resided at 107 SOUth TBylOY' . However I have changed my domic,ile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida sinoe ?th day of
_ Y~L__- . 19 ?0 , and I reside at Bt 1 BoZ 692 B
(Street and Numbsr)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declarotion of citizensl~ip, ac~ual le9al residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquiahment of employment
at former domic~le, removal of family to new domicile, purthase of home, etc.)
Entering Terry in the 2nd grade -
Terry ia stayin.g with the Edith Love~oy( Grandmother)
" ia in the cuatody of his sieter 8ose BecY
FILEO AND RECOROE01 ,
. ST.~EfORC ~ERtF1EDLA.
193156
'10 MAY 8 AM 10 ~ ~~9 ~L
nOGER r01Tt~~~~
CI.ERK CIRCUI7 COURT'
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1 RIRTHER CERTIFY that I will oomply with all othe~ raquirements of a(eqal resident of thi: State.
I FURTHER CERTIFY that I have no intention to retum to my former domiGle, and 1 intend to remain in FORT
PIERCE, SAIN7 LUCIE COUNTY, FLORIDA, permanently.
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~ SW ' r ibed before me this 8th day of Ya~ , 19~~
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~ ROG~:,IiQ~TRAS
t`tR~tl~ ~ Notary Public
.~..~.c~C~-
By D.C. My Commiuion expires
(To b~ ~x~euhd in duplieat~ sed ori~nal fil~d with q~rk Grarif Coue~, and dupliu~a wiM~ Tax A~a~.)
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