HomeMy WebLinkAbout2212 i~"~l~
~e~laration of t~nnicile a~nd CitiZ~nship
TO TFiE: STATE ANU C'OUNTY TAX ASSESSOR,
ST. I,UCIB (•OUNTY, FLORIDA:
This is my declaration oi' Domicile and Citizenship in the State of Florida that t am fiting this day in
accorclance, and in conformity with Section 2?2.17, Florida Statutes.
I was formerly a tegal resident of FORT VALLEY , GEORa2A ~ and 1
(Cl'tY1 (Stats) ~
resided at CHURCH STREET . However, I have changed my domicile to
(Strcet and Number)
and am and have been a bona fide resident of the State of Florida since ~~t • day of
_Se.pte~ber , 19 48 ~ and t reside at 1004 3outh 8th Street
(scr«t.oa tvumeer)
~'ort Pierce , St. I~ueie County, Florida, ~
tc~ir) -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State j
of Florida. ~
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(inserl here any pertinent tacts, such u sale of property or busi~ess, or relinquiahment ot employme~t at tortner +
domic~le. remoral of family to new domicile, purcAase of home, etc.) .
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THIS IS TO CERTI~'Y THAT JIILIT ANAA AARRI3 the daughter o! f
l~redrica L. Harris has been a Yesident ot ~'ort Pieree
3t. Lucie Count~r, ~lorida ror tre pn~t 16 years.
i~~~v°c
F~Su°x~r~~~.
CIERK ~
RCIl1
OOU .
~EC~pO VER~FIEO
~ t` q 'lt
228155
,
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~ I FURTHER CERTIFY that I will register at my locai address when the registration books reopen, and
~ comply with ail other requirements of a legal resident of ihis State. ~ ~
~ I FURTHER CERTIFY that I havs no intention to return to my former domicile, and I intend to remain in
~
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; ~'ort Pierce St. Lucie , County,
~ Fiorida, permanently. (c'~''~ ~--J c7
' . . Ll' ~ C ~'/~JL.vL~
,
` - : ~ . ~'REDRICA Z. HARRI3
. ~ ` '
; ' ''~V~ ZI~+G
~~~=w (Name)
~ - • } 4 ~ . F ~
° - ~ ~'s 1004 3outh Sth Street
~ - - ~ ~ ~ ~ ~ (waar~~
' ~ • . ~ -
_ ; ; - l~ort Pieree, ~'lorida 33450
Y : •
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` Sv~tn,to,and sub~be~before me this ~~h day of
: ~
€ ~D~~E - c~~```~` , A. D. 19~-. ~
~ ~
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f BYs ~ D.C.
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s
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~ (To be esecuted in dupircate and oriytinsl fdtd with Cltrk Circuit Court, snd dupticate with Tu Atte~sot)
; 600K~1 PACE~I10
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