HomeMy WebLinkAbout2651 Declaration ot Domicile and Citis~nship
TO THE STATE AN~ COUNTY TAX ASSESSOR. ~-12_1_3~_
Sl. LUCIE ~OUNTY, FIORIDA:
This is my declaration of pomicile e~d Citize~ship in the State of Florida that 1 am fili~g this day in acmrdance and i
~n co?+formity with Chapter 222, Section 222.17, Florida Statutes.
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Yncon Georgia '
1 was formerly a legat resident of . ;
- _ (City) (State) ~
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1046 Aeh Street ~
and I resided at - - - . - - - - - - However I have changed my domitile f
(Street a. ~d Number)
to and am and have been a bona fide ~esident of the State of Florida since 15 day of
_~u$uet 19
68_, and I reside at 516 B lforth 23rd
- (Street and Number) - -
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual leg~l residerece and ciomicile in the State of Flo~ida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment }
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
Eatering Child in School
Robin Tslaine Brown - 10 ~~are
2_12_L31
FILEO AND RECOIfpE~ . ~ `
iT.lYC1E COUNTY fLA. "
ROCER POITIUt
CLERR CIRCUIT COIIRT
RECORO YERIFlEO~~ .
~ ~ ~1. ~Z ~0 59 ~'7{ ~
~~r~.
~ _
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1 FURTHER CERTIFY that 1 wilt comply with all other requirements of a leybl resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domic.ile, and I intend to remain in FORT
;
PIERCE, SAINT LUCIE COIINTY, FLORIDA, permanently. '
. . ~ -
~ju~ ~-L~
(Nam~) ~ C~ ~8
~"G ~
';:,;,~i~ 516 B North 23rd Street, Ft. Pierce ~
. ~ (Address) !'lorida
~ - ~ ~
~ ~.Sworn t~c~ a~ii~vbscribed before me this 12 day of _ J~~ , 19 71
' , Y
Roc;~ rom~ws ~
CLERK CIRCU COURT Notary Public ?
:
;
ey D.C. My Commission expires
(To M~ ~x~cut~d in dupliul~ and ori~inal fil~d with CINIc Grcuit Courf, and dupliuN with Tax Ast~ssor.)
dovr, l~ ~48
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