HomeMy WebLinkAbout1702 ~
Deciaratlon ot ~omicile and Cilizenship
TO THE STATE ANO COUNTY TAX ASSESSOR ~~v~vV'
51, lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordanco and
~n conformiy with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of I!BM?Z'e11C@_ _ _ _ _ 121t~______
, (C;ty) (State)
~ 2412 Pendletan Pike
and I resided at _ _ _ However I have changed my domic,ile
(Street a~d Number) ~
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to and am a~d have been a bona fide resident of the State of Florida since 3rd _ day ot ;
Sept_ _ ~9?~ and 1 reside at ._913 _Bluefish Court ABC Mobile Home__,
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Florida.
(Inserr here any pertinent fads, such as sale of p~operty or business, or relinqu~shment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering JohnR. Brannon in the 6th grade
" L;ichaZl i~h the 6th grade
F~LED"AND RECORD~tS~
ST. LUClE COUNTY. FLq'
RFCORC VFRIFIEO
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'TO OCT 8 AM I I~504~~
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~ ROGER POlTRQ$ i
~ GLERK CIRCUIT COURTJ
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1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. #
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I FURTHER CER3IFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. t
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• ``~ti~~ f•,1i~ `r, ~ ~ j
' . (Name) ~ ~
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~ .~~r'-~~#t~ t'I- Ruth West ( l~rs Henry D ) :
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Y ` (Address) tj
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•::~:'~t ~ 8th October 70 t
- '~Swem to ~nd subscribed before me this day of , 19 . ~
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Roc~ rom~ws _
CIRCUIT OURT Notary Public
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By ~ D.C. My Commission expires
(To b~ ~x~eut~d in dupliut~ and ori~inal fil~d with Cl~elc CireuN Cour~, and dupliu» with Tax Ass~ssor.)
• ~~8? ~17i0~
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