HomeMy WebLinkAbout2082 . Uc:Gl.~r< <ic~~~ ot f~oi.iir.ii:: ~:~~:i Ci:i::~~i::~~tn
10 THE STAIE /1ND CUUNIY TAX /~`_,:,l.`,.`~OI~. ~~`~~la~5
51. lUC1E COUN1 Y, FLORIDA: ~
This is my declarotion of Oomicile and Citizc~ship in tho State of Florida that I am tiling this day in atcordance and ;
in conformity with Chepte~ 2~2, Section 222.17, Florida St~tutes. . ~ . j
1 was formerly a lec~al resident of • CL E V E L A N D T E N N ~
(City) (State)
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end I resided at _159 5 BE t~1~F0 N P I K E - . However 1 have changed my domiu~e
• ' (St~eet and Number) •
to end am and have been a bona fide resident of the State of Florida since 18TH day of
' , ~P.O•Box 3654~
• APR I l , ~973 , and I ~eside ~at 3221 S• FEOERAL HMY, FT PI ERGE '
• . (Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ' ~ ~
and this statement is to be taken as my declaration of citizenship, actua! legal residence and domicile in the State of Florida.
(Insert here any pehinent facts~ such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.) .
Applying, for Homestead . ~ -
- Entering children in school : - - ~
~ . CaREGORY MI KEL - 12 YRS '
' fILEO AND RECORDE~
' iT.l1iCIE COUNTY fLA. . ~
aJl MNY M1 KEL ~ 11 YRS • ' tiOCER P0ITRAS ;
~ ' . C~ERK Ct3CUtT COU TI~,,u~W . . '
_DARL ENE ~ - RECORD VER~FIE4~...-~-~ !
CHARL ENE- ~11 KEl ~ 9 YRS.'. . ~ 3 09 ~~13
~ • SAND•RA KELLEY ~ 18 YRS. •
! , ' ~ '~53455
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1 FURTHER CERTIFY that I will comply wlth all other requirements of a legal resident of this State. ;
I fURTHER CERTIFY fhat I have no intention to return to my former domiule, and t intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. '
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~ _ • MRS. (Name) DONAlO _MI KEL
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~ P 0 Box 3654 - FT PIERCE F~ 33450 ~ ~
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~ . (Address) _ ~
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~vVarn;lp~y~;wpscribed before me this 3R0 day of M~Y ~ ~q 73 . ~
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G~~ Q~y.., ~ : . .
~ 4 ~ - 1
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~1,~ ~ C .~Q'URT ~ Notary Public
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C • 1,•~ ~ ' ~ s
y " ~ ~ D.C. My Commission cxpires
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~ ~ z - s ~213 f~~20i9
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(To bo oxocutod ~n cluplica~o ind ~••~~~al filoJ will~ ~lork Circuit Court, a~.d duplicato with Tax Assossor.)
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