HomeMy WebLinkAbout0476 Declaration ot Domicile a~d Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUC1E COUNTY, FLORIDA: ~
This is my declaration of Domicile and Gitizenship in the Stata of Florida thst I am filing this day in accordance and
in conformity with Chapte~ 222, Section 222.17, Flo~ida Statutes.
I was formerly a legal ~e:~de~,r of Algonquin I11 _
(City) (State)
and I resided at __16 Hillr I,eAe However 1 have changed my dcmic,ile
(Street and Numbe~)
to and am and have been a bona fide ~esident of the State of Florida since _ 4 th_ day of
_l[arch ,~9 and i reside at 120 I,akehurat Dri~e Fort St. I,ucie
(Sheet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Inse~t here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domiciie, purchase of home, etc.)
22490'~
Entering ir_ school - ~~M~~
ItOCf R POITR,?a
CLfR~ CIRCWT COIIAt
Ke~in in th@ 4th grade RfCORO YER~F~EO..~,~
Kell~ in the lat grade
M+r i 12 sz PM'11
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~ I FURTHER GfitTIFY that 1 wilf oomply with all other reguiremenb of a le~al resident of this State.
~ 1 FURTHER CERTIFY thst I have no intention to retum to my former domicjle, and I intend to remain in FORT
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~ PIEi~(~~`,~11N`f, Ll1C1E COUNTY, FIORIDA, permanently. .
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~ • (Name)
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~ ~ Judith Ann Ca~pbell
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}s , 5worn to and subscribed befo~e me this 6th day of ~[BPCh , jq~~
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~ ROGER rOITRAS
a2 CIRCUIT COURT Notary Public
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~n By D.C. My Commission expires
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~ tTo b~ ~x~evl~d ie duplieah and ori~in~ Al~d with Cl~elt qnuh Cour~, and dupfieat~ with Tax As~.~
gooK200 ~ 476
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~ No. 13~'
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