HomeMy WebLinkAbout1312 Decla~ation ot Domicile and Citizenship
~:2~.3388
TO THE STATE AND COUNTY TAX ASSESSOR, ~
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Sl. IUCiE COUNTY, FIORIDA~ ~
This ~s my decfarat~on of Domicile and Citizenship in the State of Ftorida that I am filing this day in accordance and ~
~n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of _ DLib11ri . Ge01"g19 {
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(Ciy) (State) '
and I ~esided at _ GQi_ 1Nest_ ~Y@Y1Lie _ . However I have changed my domiCile
(Street and Numbe~) ~
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ro and am and have been a bona fide resident of the State of Florida since . 2.~ 8~ _ _ day of ?
- - IlBC6sbQr _ 19_7~ , and I reside at ~04_Apt A 31 st St. _ _ _ _
(Street and Nurnber)
FORT PIERCE, SAINT lUC1E COUNTY, FLORIDA ;
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Florida_ ~
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
Place child in echool.
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I i11ED A~ ~ sE~~~pEO
Jaequeline Harria 9~ears sT ~~~Jx7rF~
~ pOZi. =JITRAS
; CL£~x L' ~ ~~r COURT C~ '
~ NECC~p!! Vr~ ,r c~~~ !
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~ ~e l i2 ss PM '71 ~
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" 22,3388 l
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~ I FURTHER CERTIFY that ! will comply with all Nher requirements of a legal resident of this State.
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~ I FURTHER CERTlFY that I have no intention to return to my former domiu~e, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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" - . (Name) - ~
• . ; ~ . . Barbara Harri s ~
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. 90l Apt. A 31 st St. _ - ~
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th Februar 72 ~
Swo to and subscr~bed before me th~s day of , 19 . ~
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ROGER POITRAS ~
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= CLERK CIRCUIT COURT ' Notary Public ~
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_ By _~c D.C. My Commission expires ~
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(To be sxecuted in dupliute and o?isinal ~iled with Cl~rk Grcuit Cou?t, and dupliute with Tax Assessor.) ~
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,3 A ~199 ?~1311
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