HomeMy WebLinkAbout0234 ~eClaration ot Dottticile and Citizenship 2 0 6 4 0 0
TO THE STATE AtVD COUNTY TAX AS,SESSOR,
51 LUCIE COUNTY, FIORIDA
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Th~s ~s rny declaranon of Dom~cile and Citizenship ~n the S~ate of Fiorida that 1 am f~l~ng th~s day in accordance and
n conformity with Chapter 222, Section ?22.17, Florida Statutes
t was formerly a fegal resident of Rootstown Ohio _ _
(C;ry) (State)
~nd I ~esided at 3546 _SR 183 Nowever I have changed my domicile
_ (Street and Number)
fo and am and have bee~ a bona fide ~esident of the State of Florida since 15 th day ot
March ~1 810 N. 7th St.
. 19__ , and I reside at - •
(St~eet and Number) ;
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FORT PIERCE, SAINT LUCIE COUNTY. fLORIDA ~
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and this statement is to be taken as my dectaration of citizenship, actual legal residence and domicile in ihe State of Florida. ~
(Insert here any pert~nent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, pvrchase of home, etc.)
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(School Children)
Jacqulinn flefner - llth Grade 2 0 6 4 ~ ~ ;
Larry Hefner - 6th Grade FILEG 1tMD RECOR~EO
sT. ~uc~E cauKTr L~.
Gar Hefner - 7th Grade ROCEP ~O~T11AS
Y CIERK C~~CUIt C011RT
RECORO YEa~F1E0
Rosemary ~Detwiler - 7th Grade ~'g Z 19~~=,
Perry Det:viler - 2nd Grade
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~ 1 FURTHER CERTIFY that I will comply with all other requirem~nts of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retum to my former domiUle, and I intend to remain in FORT ~
; PiERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. _
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~ (Name) Ralph ~i . etwiler
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(Address)
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Sworn to and subscribed before me this ~
1-~-h-- day of - - 9~arch _ 19-- i
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- ROGER POITRI~. ~ ~ - - - - - - - - - - - - - - - - - -
CI~T Q~U Notary Public
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8y _ - -r D.C. My Commission expires - _ _ _ . _ _ _
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~=y (To bs ~sa0fed-io,,drplit~la;~snd ori~inal filed with Cl~~lc Grcuit Court, and dupliats with Tax AssessorJ
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