HomeMy WebLinkAbout0541 D~ala~atlon ot Don~iail• and Citi=~nship
TO THE STATE ANO COUNTY TAX ASSESSOR..
Sl. LUCIE COUNTY, FIORIDA:
Thii i: my declaretion of Oomicile end Citizenship in th~ Stste of Florida that 1 am filin~ this day in aooordano~ and
in confo~mity v~rith Chapter 222, Settio~ 222.17, Florida Statutes.
i wa: formerly a le~al ~esident of 1~i8~i FlOridB
(CitY) (Stah)
and 1 ~esided at _ 3200 1~W 79th St. . Howevsr 1 have cha~pad my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida s~noe 14th ~ay
~ _ Juae , 19 7Q and ~ roside at 907 Ave ~t _
' (Street and Number)
FORT MERCE, SAlNT tUC1E COUNTY, RORIpA ° .
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busi~ess, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(School Children) ~
X]6~ X
Betty Z. Vest - llth Grade FI~LO ANO RECORDED
ST. WCIE COUNTY. FLA.
Dee B. Clemmone - 5th Grade ~ECOR~ V~RIFI~p
, 196"f~?'4
. 10 AUG q AM 9: 3 g
~ ROGER POt7RAS
CLERK CIRCUIT COURT~
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,
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~ 1 FURTHER GHtTIFY that l will oom with all oth~r r uiremsnri of a I I restdsnt of this Stsb.
P~Y eq ~
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I FURTHER CERTIFY that I have no intention to retum to my former domic,~le, and I intend to remai~ in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permsnently. D018II B. C18IDmOII8 ( I~B. Charlotte P. ~
r
~~a,r~~i .
cr~lame)
(Address)
Sworn to„4nd subscribed before me this 4th day of ~u~st , 19 .
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G . i ~ ~ Not~ry Pub~k
' •:w' D.C. My Gommiuion expires
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