HomeMy WebLinkAbout0162 claratian af Domicile and Gi~i~ensh~P
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ST, LUCiE G~uN~rv, F~oKinn: ~
11~is is my d~claration of Uomicile and Citizrnship in thc St.11C O~ FIOfI(I1 thal 1 am filing ihis day in
.,ccorclancc, and in conformity with Section 222.17, Florida Statutcs. ~
York _ pA and I
1 was fornicrly a lcgal resident of - ~~~~y~ ' ~s,,,~~
-r . However, I have changed my domiciie to
residcd at 324 S. She7~'O48I1 St.
,r~~ (Street and Number) +
25th day of ~
a~~d am and have bcen a bona fide resident of thc State of Florida since
' e at Rt. 1 Box 351 ~
November , t 9?3 ; and 1 res,d ~5~~~ and Number) j
Ft. Pierce St. Lucie County, Fforida, i
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ancl this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ;
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of Florida.
(Insert here any perlinent fxts, such u sale uf property o? busincss. or relin9uisl?ment of employment st former . ~
domicile, removal of family to new domicile, purchase of home, etc.) ~ t
ENTERING CHILDREN IN SCHOOL: HOMES AD.EXEMPTION: ;
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If entering children in school,
please list their names:
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~ F~IEa ~4'-' k~COR~EO L .
ST. lUC1E ~~UMTr flA. ~
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C± ~Er C.'~UIT COURT
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I FURTI~ER CERTIFY that 1 witi rcgistcr at my local address when the regi$tration books reopen, and
comply with all other rec~~airements of a legal resident of' this State.
I FURTHER CERTIFY that 1 ha~e no intention to return to my former domicile, and I intend to remain in ~
Ft. Pierce ST. LUCIE County, R-,, `i
(ciir) ~f
Florida, permancntly. , ~ ~
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~Kix~o and su~~S+~df~d be.orc me this ~ay of
~ U a-~' -i'~.It-~• A.D. ly_74l - Rt. 1 Box 351
~~.+a 1 ing ress ~
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By ~ ~ . . -
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MY COMMISSION EXPIRES ~D G~~ ~Ci~"''""v
F NOV. 2~. (1~~/ execuled in duplicate nd ~~rigin~l f~led wilh Clr~k ('ircuil Cnutl, anJ duplicate with Ta: Assesux)
~ yORK, YORK COUNT.Y~ WC e 225 PASE j~~
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