HomeMy WebLinkAbout1526 i+. ~
~ ~
:a
i
Declaration o! Domjcile and Citlze~ship '
TO TiiE STATE AND COUNTY TAX ASSESSOR, ~f I
215467
Sl _ lUC1E COUNTY, FlOR1UA:
This is my declaration of Domicile a~d Citizenship in the State of Florida that I am filing this day in accordance and i ~
I
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resideni of d ~ n n ' !
(City) (State)
~
~
and I resided at - A-V~ . However I have changed my domiti~e
(Street and Number)
~
to and am and have been a bona fide reside~t of the State of Florida since r day of
_~~P~'1.[!-~ , 19
~ ~ , and I reside at 1 1 ~ E • l MCL. ~ 1 ~U ~V d • J `T • •L~d
(Street and Number)
;
FORT PIERCE, SAINT LUCIE COUNTY, fLORIDA
and this statement is to be taken as my declaration of citizenship, adual legal ~esidence and domicile in the State of Flo~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of empfoyment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.) ~ '
I d rex~ s c h o o/: ~j9
/'Y) ~ c h a e i ~CIY)') eS ~ f Ilfp p~y REGOADED
s1.111C1E ~P~
tAAStA.
itOCER ~t COUaj ~
1~'7 O/Yf Oc S ~U,S-~,~Oh g' CLER VERIftfO
aECaao aN ~
S~-e_v~ ..lo h rr 'I 13 14 29
i~I ~~t- S cho o I:
e.r I ,`~15i~~
y ~
;
~
;
~
~
E
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
~ ~
I FURTHER CERTIFY that I have no intention to retur~ to my former domicile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
C./ Oi `1/1 - - .
- - . - (Name)
. ~ - , Christine Trainor
. .4.y- . ~
fi
I /
r~
~ - . ~'{c~
; ~ ~ ~~~a'NQ. U.(~LLL• ~1d .
~ _ 7 (Address)
[ f' ~ .r , .
• S , - ~
. <f.. i q~~: {
, Syrqcrti i!~•~d~#ti~Scribed before me this day of ' , 19 i
^ i
~ . ,~~~1~~, _ t
~'RCV~R ~VITRAs
CLERK GIR IT COURT Notary Public
By ~ ~D.t. My Commission expires
(To b~ ~x~cut~d in duplicaf~ and oriqi~sl filed with Cl~rk Grcuit Court, and duplicat~ with Tax Assossor.) '
- `
- _ ~
t~ ,3 ~ ~~~5~4
- - _ . - ~