HomeMy WebLinkAbout2248 Decieration of Domicile ~nd Cititenship ~
"I'O THE ST TE ANU ('OUNTY TAX ASSESSOR, ~1~
~~1- COUNTY, FL.ORIDA:
71iis is my dcclaration of Domicile and Citizenship in the State of Florida that am filing this day in
~ccordance, and in conformity with Section 222.17, Fior~a:~ ~tatutes.
1 was formerl a le a! resident of`_~ , ~1 ' and I
Y g
/ (cilr) (Stace)
r~sided al O! U 1~n v S~ ~~sl . However, I have changed my domicile to
(Street and Number)
:,nd am and have been a bona fide resident of the State of Fiorida since ~ day of
' , 19~_~__, and I reside at v~~" r G~ ~ ~ ~
1 Street aad Numbet)
~ C /T ~v ~¢T ~ a: . ~ ~ 1~v 1 ~ County, Florida,
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
af Flotida. ~
(Iriuit Aere any pertinent facts, such as sak of properiy or business, or relinquisAment of employment at former
domicie. remoral ot family to new domicJe, purchue oi home, etc.)
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RIITH ANA IdIIISA Age 6 ~ ~
~
To eitnblish reridence and enter-ckild in school oi St. I,uaie
CountT, ~'lorida,
F ~Q AMD RECORD~ ;
~ ROCER PO
tR
S . '
CIERK C~~~ult COURT =
~ AECQRO YERIrtEO ,
. ~ t~ y~ (~'ZZ
~28188
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~ 1 FURTNER CERTIFY that 1 will register at my local address when the registration books reopen, and
i comply with all other requirements of a legal resident of this State. i
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~ I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in i
~ ~ ;
(ifhite Cit~) ~'ort Pierce , St. Zucie , County,
' Florida, permanently. ~
' • DOHAI,D Z C BE
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! ~iv~~fin to-and~su~sc'l~e~.~efore me this 2 th day of 1~'ort Pier~e ~ l~loride 33450
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' ~ A.D. 19 72 -
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~ ~~'-~~F.it~~~RA3; ClerY Circuit Co f
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i (To be e:ecuted in duplicate and ori6inal fded with Clerk Circuit Couti, and duplicate with Tu Asses~or)
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