HomeMy WebLinkAbout2593 O~alaratlo~ ot Domlall~ a~d ~itis~nshlp
TO THE STAYE ANO COUNTY tAX ASSESSOR,
51. lUC1E COUNTY, FIORI~A:
This ~s my declaration of Oomicile and Citisenship in the State of Florida that 1 am filin9 this day i~ acco?d~nte snd (
~n conformity with Chapter 22?, Section 222.17, Florida Statutes. ~
I was forme~ly a legal reside~t of _ _ _ R 1 C~IIDOIld _ _ _ _ _ _ _ _ _ _ _ _ V ~~II 18 _
(City) (Stah)
I
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and 1~es~ded at _2908 Jefferson_ Davis Hwy. Ho~,,,ever 1 have changed my domitile
(Sireet a~d Number)
to and am and have be~en a bona fide resident of the Stafe of florida since _ 15 ~ day of
- _July-- 19_?0 and I ~eside at ABC T~'Bilel' Coutt 2~5th St.-
' (Street and Number)
FORT M~CE, SAINT LUCIE COUNTY, FLORIDA
_ {
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. ~
~
(Insert here any pcrtinent fatts, suth as sale af properfy or business, or ~elinquishment of employment
at form~ domicile, removal of family to ~?ew domicile; purchase of_ home, etc.) ~
~ (Sahool) -
~Pillia.m E. - 6th Grade
Debra Jean - 6th Grade FIrEfl AND~RECORD~~~,:.
S7.~l~CORC VERIF EDLA~
1981E~"~ ;
- 'i0 SEP 9 ~ 9:25
- ~
' ~O~~R s-OITRAS ~
CCERK CtRCU1T COURT~
i ~
i ~
~ .
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1 RJRTHER ~HtTIFY that 1 will oomply with all other raquirsme~ts of a le~al ~esident of tfiis State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I+ntend to remain in FORT
PIERCE, SAINT LUClE COUNTY, FIORlDA, permanently. J874ee Brandenburg
r
(Name)
~ (Address) ~ ~
~
Sworn to and subsuibed before me this 9th -day of September ~ 19 ?0
~
RO~R ?WTRAS , -
C~W1T .y3r'• : Notary Public ~
•J- ~
BY ~ " D.C. My ~ommission expires
' - . - •
~ ~~j j . 7 ~
Re b~ ~~o~f ",,.~4~'~ait~iw~l fil~d whb Cl~k CM~b Co~N, and dvpliul~ wiN~ Ta~i A~er.)
- ~ ~ s a~ 186 ~ 2586
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