HomeMy WebLinkAbout0454 Declaration ot nomicite atid Citizens'iip
TO THE STATE ANQ CUUNTY TAX ASSESSOR,
235292
Si. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17. Florida Statutes.
N eon 'Ky .
I was formerly a legal resident of . - , - - - -
(City) (State)
~x jackhom , jy . However I~have chan ed m domi~ile
and I resided at - - 9 Y
(Street and Number)
to and am and have been a-bona fide resident of the State of Florida since May . _ day ot
72 338 Hosbine St, - Ft Pierce, Fla.
_ _ - - . 19_ and I reside at - - -
(5treet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual iegal 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, removal of family to new domicile, purchase of home, etc_) ~
Noah
Larry
entering children in public school
fILEG ANO RECOROED
SL ~tlCIE COUNTY F~A_
- ROCER POITRAS ~
CIERK C?RGUtT COURT
RFCORD vEatFt~D
. Aus t~l 2 54 PN'71
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~ 235292
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I FURTHER CERTIFY that I wifl comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY~ihat i have no intention to return to my former domic,ile, and 1 intend to remain in FORT
PIERCE, SAtNT LUCIE COUNTY, FLORIDA, permanently.
~ ( . ; . _ r
3~ rs~ . ~ ?
(Name) ethany Hall
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(Address)
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~ Sworn to and subscribed before me this 1~ - day of AuguSt ~ ~ q 72 ,
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~ ROGER POITRAS _
~ CLERK CIRCUIT OURT Notary Public _
~ gy _ i~`~~'~ _ ~ D.C. M Commission ex ires - -
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~ (To be executed in dupficate and original filed with Clerk Circuit Court, and dupliwte with Tax Asseswr.)
~ OR ~
dooK205 ~?~E ~5~
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