HomeMy WebLinkAbout2261 Declaration ot Domicile attd Cit~zenship
TO TtiE STATE AND COUNTY TAX ASSESSOR,
Sl. IU~IE COUNTY, FlOR1~A~ ~0~~
Th~s ~s my declarat~on ot Dom~ule and Citize~sh~p in the State of Florids that 1 am fil~ng this day in accordanca and
~n conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
1 was forme~iy a legal resident of _._-_.~~~~l~E.T_ - ~s~~
(C;ty) (State)
and 1 resided at F.a~~~QL1Tt~~ ~ Street However 1 have changed my domiGle
. (Street aind Number)
ro and am and have been a bona fide resident of the State of Florida since ~Q.th_ day of
_IrIQY~ffib@r 19~1, and 1 reside at ~~7 L Yehur~t nrive
(Street and Number)
~ORT PIERCE, SAINT LUCIE COUNTY, RORIDA
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 pe~tinent facts, such as sale of property or busi~ess, or relinquishment of employment
at former ciom~cife, remaval of family to new domicile, purchase of home, etc.)
i
Entering cr~ildren in acrool
~ T~omas l~ ia the 2nd grade
~ STLLt1C1E COUMTr flA.
~ Yaureen in the 3rd ~rade ROCE~ F~ITRAS
~ CIERK CiFCUIT COUi1T ~
~ Ly~n Anne in ~}:e 5th grade ~ECORD VERIFIED
~ Pntricia l in tr:e 5th gracie ~EC l 12 ss PM'1~
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4 Clifford E in the 8th grade
~
~ Bathelee~s in ~~e 9th gr~de
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~ 2,~,0061
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~ I FURTHER CERTIFY that 1 will comply wish aU other requirements of a legal reside~t of this State.
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~ 1 FURTHER CERTIFY that 1 have no intention to return to my former domiGie, and 1 intend to remain in FORT
~
~ rmanent)
PIERCE, SAINT LUCIE COUNTY, FLORIDA, pe y.
~ -
~ _ , ; e
` f. f ame)
~ ~ D~rcthv A Cox ( ~rs Clifford )
_ ' ~
- . _ (Address)
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: _ . . . • , _
S~vr,ri to and subscribed before me this 7th day of Tleeemt~et , 19~1
ROGER POITRAS
RK CIRCUIT COURT Notary Public
L !1 ~'~=f ~ ~J~`2'. ~~~C. t
BN D.C. My ~ommission exp;res
:t
=v~ . 4
~ (To be executed in duplipte and original filed with Gerk Grcuit Court, and duplicata with Tax Assessor.)
- ~i97 ~ ~
- ~~58
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