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Declaration ot Domicile and Citlze~ship
TO THE STATE ANU COUNTY TAX ASSESSOR.
Si . LUCIE COUNTY, FIORIDA
(his ~s my detlaration of Dom~ule and Cihiensh~p ~n the Sta~e af Florida that I am f~l~ng this day ~n acco~dance and
,n confo?miry with Chapter 22?, ~ection ?22.17, Florida Statutes.
I was formerly a legal resident of Charleston _ S• C•
(C;ty) (State)
and I ~esided at 3749 Azr,lea KOtld However I have changed my domiti~e
(Street and Number)
to and a~n and have been a bona fide ~esident of the State of Florida since JLil~ 2 day of
, 19_~jl , and I reside at . ~~5 ~andia ~'ri~t~»-
~'Ort $t 1'LiC~@ (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of c~tizenship, actual legal residence and domicite in the State of Florida.
(Inser~ here any pe~tinent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domiciie, purchase of home, etc.)
Eetablishing residenca
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Placing children in public achool
John and Robin Faber f~~Q ~4~ RECp~p t
=T. UICIf COUNTY 1~~ d,,?~
Cl~ KCCIRCUIT ~~t
RftORD vfRIFIEO~
4
Auc 13 10 0~ AM'TI
213911 ~
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I Ft1RTHER CERTIFY t~~at I will comply with all other requirements oi a legal resident of this State.
1 FURTHER CEkTIFY that 1 have no intention to return to my former domi~ile, and I intend to remain in FORT
PIERCE, ~AINT LUGE COUNTY, FLORIDA, pe~manently.
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. C~,~,t,
(Name) Paul L. Faber
(Address)
Swom to and subscribed before me this _ _ _ L_~_ _ day of _ _ _ _ . _ ~ ` ~ 19~
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ROGER.lQKRAf~~`~~ ~ - - - - ~
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CLERI( C1RCUiT ~OURT. Notary Public
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By ~ D_C. My Commission expires
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(To b~ ~xecut~i~d in ~sGrplitat~ and origieal filed with Cl~rk Grcuit Court, and dupiicate with Tsx Ass~ssor.)
~ ~3 ~,~~R 194 2229
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