HomeMy WebLinkAbout0757 Oeclaration ot Domicile and Citise~shlp
TO THE STATE AND COUNTY TAX ASSESSOR, '
Sl. IUCIE GOUNTY, FIORIDA:
This is my declaration of Domicile and Citi=enship in ths State of Florida that 1 am filin9 this day in aooordance and
~n confo?mity with Chapter 222, Section 222.17, Florida Statutes.
I was fo~merly a legal ~e:~def,~ of _ Plainfiled llew Jer~e~ _
(City) (State)
and 1 resided a~~33 weot _ 6th streAt ~Wever 1 have changed my domivle
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since l~~ _ day of
_ Yovember , 19 70 , and I reside at 4309 ZvA. d.
~ (Streef and Number)
F6RT MERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here a~y pertinent facts, such as sale of property or businsss, or relinquishment af employme~t
at former domicile, removal of family to new domicile, purchase of home, atc.)
.
$ntering children in eohool- _
Douglae in the 12 th grade ~
Zee in the lOth grade '
Baren in the . 8 th grade ~ U.
D e b o r a
h i n t h e 7 t h g r a d e r..~
_ Bathle en in the 5 th grade 9~~~
genneth in the 3rd grade
~oa9~, -
~
~ ~ _
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1 RIRTHER CERTIFY that 1 will oomply with all other requireme~ts of a tayal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domiule, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. -
,r; :
Name)
`~.t~:,+=~ru:ir~ ,~t Ast~ A. - elaoa Jr.
; . . .
,r''-~ ~ ~.li~:;;`Y i ~
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t` ':•'e.~# c.'•.,.'~,•~?a G~~in .~.~-r.
~.~;f~~ih. ~
; G~
.rs! • - Doreen V. Beleon
_ , = _ t ,
~ ~ ~ ~ ~ 16th Aovember 70
~v: ~~~6t a~d;ubsuibed before me this day of , 19 .
~ `
~ ~~~~r r C~U~~_0.~- ,
~
~ CNtCWT COURT Notary Public
~ Q~J D.C. My ~ommission axpires
Ro b~ ~x~cuNd in dupliuN snd ori~inal fil~d wilh Cl~lc Grarh Courl, and dupli~aia Mrith Tax Ass~sso?.)
~ ~ „ goo~ 188 .756
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