HomeMy WebLinkAbout0463 Declaration of Domicile and Citizenship
241859
TO THN STAT~ AI~'U COUNTY TAY ASSf:SSOR,
St. Lucie- - - - - ('UUNTY, FLORIUA:
Tlti~ is my dcrlaration oi~ Domicilr and Citizcnship in thr State of Florida th:~t 1 am tiling this day in
acrordance, and in conformity with Section i 7, Florida Statutcs.
I was formcriy a ie~ai rrs;d~nc of _ _ _ . ~r~en~ri].~~_ , South /Carolina__ ;,,,d ~
(City* (State)
r~sidcd at _ _ --_-I?llkelarid_D~~.YE- - _ . How~ver. 1 have changed my domirile to
(Strret and Numbrr)
and am ~nd have b~~n a be~na iidr residcnt uf the State of f~lorida since __30th ~ay of
- --_--_~~tober--_- _ . 1~72_ and I r,sidr at ~606_--RQ?~at
(Sire~t and Number) ~
- -.----Ft._. Pi~r~~ • St. Lucie ' County, Fic~rida.
(c'i~y )
and this statement is to he t:~k~~~ as my dcclaration of citizenship, actual legal residence and domicile in thr State
of Florida.
(Inser: hrrr any p~rtmcnt (arts, ~uch as,alr of pmprrty or businrc~, or rrlinyuishment of rmployment at fotmer
di~micile, rrmo~~l of famil~ to new d~~mic~le, purch:+sr of humr, ric.)
Establishing residence and placing children in schoool
241859
fi~~o aHfl RECOROEo
at ~uci~ couNTr f«.
ROGER ~OiTRAS
CLERK C~~?~UtT COURT
RECORO VE~?IFIEb„_„~
I~ 13 IO lv AH '1Z
~ ~
~
1 FURTHER CERT(FY that 1 will rr~_i~trr at my loc:al address when the registration books reopen, and
comply with all other requirements oi~ n I«;~I resi~ient of this State.
1 FURTHER CERT[FY th:tt ( h:+ve no iniention ta return to my forn~er domicile, and 1 intend to remain in
Ft. _ Pierce _ _ _ _ _ . st. Lucie ~•~~.,,t`,
_ _ _ - - - - ~
Florida, perfnli~ently. ~ ,
. .
~.~JOt;L'„''~!, ' _
,
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.
~ n~~l.~ ~ '
~ (Name) - - - - - - -
o' ~ - Ruby C Millis ( Mrs Wm
. .
~ ~ , ~ -
: ~ : _
• ~ -
~ ! : _ - - - - - -i~aa~~u~ _
-
!''Swoe~t~•~~cT~eilbseribrd.befo~~ m~ chi~ _ 13t.h ~],~y c~('
; t ~
NQV~m~~x A. ti. t~~ - 7 2--.
_ ~c-tu ~~'O-L-~t
- - - - _ - - - - -
Nutary Public Staie uf Florida at ( ar~r
' h::T: t~.! r i t~'.;:)a ar 1 AG";
~t ('ommission c~ ires. r. Y ci; ' . ~;;s . .f_; ~~n~. 15, 1976
y ~ &siiC~E£ iF•:it~ -:~(:.[:::~L-ltw::..:.:?.;~-iLi.;t,:+ini1ERS
(To be rxrcutrJ in duplicatr and ~~nfmal filed with ('lerk Circuit Court, and daplKatr ~~~th Tax Assessor)
doox 208 ~~c~ 4~
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