HomeMy WebLinkAbout3952 Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TA~ ASSt~.SSOR. 244~4
ST.IUC I E COUNTY. FLORIDA:
Tltis is my declaration of Domicilc and C'itit~nship in thr State of Florids that t~m tiling this day in
accordance, and in coni~ormity wilh Sc:ctiun ~_".17, Florida Statut~s.
I was formerly a Iegat resident of g~ U E F I E l WE S T V 1 R G I N I A__._ ~nd 1
. (Clly) ($lalC)
rc~ided at 1264_ HEAT_NERVO00 _RD.IEXT. . Howrvcr, I have changed my domicik to
(St~rrt and Numbrr)
and am and have bcen a bona fde rrsidenl of th~~ State ol~ Florida since _19T1~________ d:~y ot
~ECEMBER , ~q 72__, and I r~sid~ at 82fi__S•E. ~EGAN ~Rf.VE, PoRt ST _Luc
iF
(St~cet a~d Number)
FORT P! ERCE ST. I.UC 1 E County, Florida,
- •
Il'ity)
and this siatemrnt is to be tak~n as my derlarati~n ~~f ritizensl~ip, actual legal residence and domicile in the State
of Florida.
(losrri herr anp prrtin~nt factx, wrh a. ~ate uf pruprrty nr husiness, ur relinyuishment oi rmployme~t at former
domicile, rrmo~al uf family tu nrw dumicite, purchase of h~~mr, rtr.)
KAREN CHRIST~NE NXKK HAYNES ~ 6 YRS
~1.1.11~it~ ~ i
AOCf~ PG~T~t ,r-~
- ~C~~"~itR r
ffl~ ~
Q~c 1i I~ ~N'11
244244
~
' 1 Fl,?RTHFR CERTIFY that 1~ti~ill re,~istcr at my loc.ii :~ddress ~vh~n [he registrati~n books rco~~ii. astct
~
' romply ~ith all othrr requirements af ,i le,~al r~sid~>>t of this Statr.
i
; 1 FURTHER CERTIFY that ! ha~-e nc~ intc ntic~~~ to return to my form~r domicile, and 1 int~nd to remain in ;
~ FORT PIeRCE__--- _ _ - _ . _ - S? LU.~1-E-------------• (~o~nti~. '
~ Florida, permanently. ~
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NN Ea HAYNES ~me~ c
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,,`~N~~~H~.~~~~~~ = - ( lddrrss) .
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Sw'oN~Xoand st~i~~ir~ib~d before m~ ttu. _26 ~l:i~~ c~f .
,
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• . : : _
-r 'D ~[NBEI!•J'_- _ _ . .D. 19_'2 . f
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; = --rr-=------
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~ ; ~ Not~lYPublic Slate uf }I~inda al (_3r O R f1 ~tt
' ~--~n ~ ~ c 7 600K tl ~wuc tl
tity•Comfttission expires . _ _ _ . ~ _ _ c~
, ~ /
(To br e~rcutrJ in dup6catr anJ nn~in.d filed ~~~Ih ;'lerk l'ircuit C~.urt, and Juplkate with Tax A~sessor)
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