HomeMy WebLinkAbout2629 ~eclaration ot Do~icile and Cilizenship
TO THE STATE AND COUNTY TAX ~~SSESSOR,
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5~ . WCIE COUNTY, FIORIDA: ~
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This is my declaration of Domicile and Citizenship in the State of Fiorida that 1 am filing this day in acco~da~ce and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a lega) resident of ~•e8dV~11@.._ _~@IIA. _
(C;ty) (State)
and I resided at Rd . 1 _ _ Nowever 1 have changed my domiGle
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since 5 th _ day of
October , 19_?~ , and I reside at _ 513 _5. 33rd St. t
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(Street and Number)
FORT PIERCE, SAtNT LUCIE COUNTY, FIORIDA
ar.d this statement is to be taken as my declaration of citizenship, actual legal resid~nce and domicile in the State of Florida.
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(Insert here any pertinent facts, such as sale of properiy or business, or reiinq~~ishment of employment
at former domicile, removal of family ta naw domicile, purchase of home, etc.)
{School Chil3ren) ~
FILED AND RECORDED
ST. LUCIE C~UNTY. FLA.
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Howard ~~$Z~~ - 7 th ~rsa e _ 2~0194
Charles - 5th Grade '70 ~~T 26 AM 9•
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~ ~O~E~R ~'OITR:.S
CLERK CIRCUIT COURT
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~ I FURTHER CERTIFY ihat I will comply with all other requiremenis of a legal resident of thia State, f
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~ I FURTHER CERTIFY that 1 have ~a ~ntention to return to my former domic,ile, and I intend to remain in FORT ~
~ ~~ERCE, SAINT IUCIE COUNTY, FLORIDA, permanenNy. ~f`i8Tg82'ete Kelsey (D~rs . tioward )
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(Address)
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~ .;Swor~•tq and subscribed before me this ___~~1.-____ day. of __QE~4 ~?~T_ , 19~~_. i
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~ :'Gv~ - COIJRT Notary Public ~
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.~r D.C. My Commission expires t
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~ '~~~'~1 ``t~_ ' iM dupliuts and origina) filsd with Clfrk Grcuit Courf, and dupliuts with Tax Ass~ssor.)
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