HomeMy WebLinkAbout0789 Declaration ot Domicile a~d Citizenship
219Qf 5
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day i~ acco~dance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a lec3al resident of _ Point 1'1e8s1u1t _ _N. J.~
(City) (State)
and I resided at _ 2801A Bridge Avenue _ However 1 have changed my domicjle
(Street and Number)
to and am a~d have been a bona fide resident of ihe State of Florida since November 15_ _ day of
, 19 71 and 1 reside a~ __3b_Flemenco Wap - Sganish Laksa _
(Street and Number)
FORT PIERCE, SAiN? LUCIE COUNTY, FtORIDA For~t Pierce, Florida
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Donna Garris
~
s~~~~ciF cou~R~isi.
~w ~ -r~tius t,
i ~ ~D VERiF
E C~T
RECO
~ ~br Ia 10 S~ I~'11
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiale, and I intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FIORIDA, pe~manently.
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~ - - - ~
~ (Name) (b,~on Garri s ~ S
~K
= (Address)
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lg November 71
Sworn b snd subsuibed before me this _ day of _ _ _ _ _ _ , 19__.
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~-r; , .y •
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:t:= .~rae ~R~i?.`s` ~ - - -
: ~ :CIRCNIt ~ Notary Public
_ By ~ ~.C. My Commission expires
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ts, GO., .
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_ 1» ~c~wN~l iw dupliu» and ori~inal ~il~d with Ci~rlc Grcuit Court, and dupliut~ with ~ax /?ss~swr.)
8ooK1y7 ~ 7~9 '
No 13
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