HomeMy WebLinkAbout1144 ~
~ 1~eclaratt~n at Domlciie and Ci~izer~~hi~ ~
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TO TFi~ STATE AN~ COUtdTY TAX ASSESSOR, ~~~~,8~ ~
ST. LUCIE COUNTY, Fi.ORIDA: '
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This is my deciaration of Domicile and Citixenship in the Stete of Florida that i am filing this day in accordance and
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in conformity with Chapter 222, Setilon 222.17, florida Stetutes. ~
1 was forme~ly b lega) resident of A1~~ ~ Georgia
~ (City) (State) 3
and 1 resided ~t 80b ThOmas St ree t ~ , Howevar ave changz?d my domic~le
_ (St~eet end Numb~~)
b and am and have been a bo~a flde resident of the Stete of ~lorida ainca 29th day ot
~ ~ Novetnber 64 912 Ave M ~
- , 19 , and 1 res(de at
; (Streat and Number)
fORT MiRCE, SAINt LUCIE ~OUMTY, FLOf~IDA
~ and this statement i: to be taken as my t~eclaratien of citizanship, actuai legai residenco end domfcile in the State of Florida.
(insert here any pertinent facts, such as sale of properry or buainess, or relinquishrnent of employment
~ ~t former domicile, removal of family to new domicila, purchsse of home, etc.)
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bntering Edwarc~ O Yawn Jr ~n the 8th grade ' ~.31186
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,e ,e~,,,~~ ~,,,,t 64 D~C 2 p~y 21
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. ST. IUCIE C~UNT1~. fiCORID
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~;_4 ' I FURTHER CERTIFY that i will oomply witi~ ~i) other ~equtrem~snh of a legal restdent of this Stata.
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~ j I FURTHER CERTIFY thnt i have no intention to return to my former domidla, and 1 tntend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. _
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~ ` (Name)
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; ~ Edwasd Yawn Sr.
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Sworn fo and :uburibed b~f~e me tfiis 2 day of ~ecember ~ ~p 64
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' ROGER POlTRAS
; CIRCWT OU4tT Notary Public
~a,,...t.s.~ C., . ~
~ D.C. My Commisston expires
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(To b~ ~xscut~d In dupliuts ahd ori~i~ai filed vrith C1Nic qrwh Cou~f, •nd ei~up{iut~ wilh Tax Aa~o~.) -
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