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Declar~tion ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR. 22s12'~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in acco~dance and ;
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal ~esident of I.~$@1821$ . _ _ _ _ ~'~22'~~- _ _ _
(City) (State)
and I resided at _ 1_~Q~_ G8T31_~Qa$~_1iH$~~_~4Z1(~El However 1 have changed my domicr~e
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florid~siSe~rit Lucie COLiIItV day of
the - Se~ente enth - -
J-tu1e- _ t9~h~, and I reside ar __'L74_~ SQt~th Federal Hig wav ~ S' _1__
(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY~ RORIDA
and this statement is to.be taken as my declaration of citizenship, adual legal residence and domicile in the State of Flo~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
I have been a resident o~ the State of ~1•~rida since 1951
and ha~e been continuoualy Nithin the state ~rith the excepti~n
of periods of e~ploynent necesaitating ay being out-of-atate;
perioda spent in achooling; family ?acations; tripe, etc.
I hafe lived in Fort Pierce aince June 17th, 1969 when I ~
began employment as Vicar at Hol~ Faith Epiecopal Church,
Port Saint Lucie. This has been ~y home and I have reaided
here continuously ~rith the excepticn of vecations or short
trips. I am and ha~e been a resident of a8int Lucie ~ounty
aince June 17th, ~969.
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~ 1 FURTHER CERTIFY that I will comply with all other ~equirements of a legal resident of this State.
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~ I FURTHER CERTIFlf that 1 have no intention to return to my former domi~ile, and I intend to remain in FORT
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& piERCE, SAINT LUCIE COUNTY, FLORIDA, p~~t~F. ~t_1 September-Octob , 1 7~
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~ : ~ ~ ~ ~ _ ~
a :
f' (Name)
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. Sa2ue1 Sutte_ Tho~aa
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_ • Z704 South Federal Hig~i~ay U.S._1
- ' (Address)
, Fort ?ierce~ ~'l~rida. 33450
_ ' . .73
•_3Mrvt.~l,to bnd subscribed before me this ~'1 day of ~eTCh , ~q~.
~
= ROGER POITRAS
CLERK CIRCUIT COURT Notary Public
" BY ~ h«~'~' D.C. My Commission expires
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Ro be ~xscuted in duplicsh and oripinal filed with Cl~rk G~cuit Court, and dupliqts with Tax Assessor.)
~ , 3 Ea~K ~00 2~07 ~
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