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HomeMy WebLinkAbout1730 ~eciaration of Domi~ile and ~itizen~Ftip .1 ~~'~Ei(~E; ~ r TO THE STATE AND COUNTY TAX ASSESSOR, Sl. LUCIE COUNTY, FLORIDA: ~ This is my declaration of Domicile and Citize~lship in the State of Florida that I am filing ihis day in accordance and in conformity with Chapter 222, Section 222.17, Flarida Statutes. R.ic hmond Ind iana I was formerly a legal resident of _ - . (City) (State) ~ t and I resicled at 2005 L~l~erty_. Av~.,, f_________._____. . However I have changed my domi~ile (Street and Number) . to and am and have been a bona fide resident ~f the ~Sfate of Florida since . 4th_-_____--- day of Februar}? 66 1507 Easter Terrace - 19---- , and I reside at (Street and Number) F~RT PIERCE, SAINY LUCIE COUNTY, FLORIDr~ and this statement is to be taken as my decfaration of citizenship, acfiu~l Iegai residence and donlicii~ in til@ JTaTB OT YiOiida. ~ ! (Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~ at former domicile, removal of family to new domicile, purchase af home, etc.) Entering Randy Charles Mullin in school .S.,,t:?t: •;;;;t~., : ~.:;C~ _ RECOROED F ~ fILEO AND ~ : ~~L 900K ~ . ` ` • , ` ~ % I N _-~`J1TiL1a[ ~n r . . . : ~~p~~/~l' l y y . - . . _ , ~ pM 9:Oy . ; - S6 FEB ~ ~ ~ ~ ~ _t_~~E}i~l ' ? ROGER r'Ot i RAS. CLERK • : ~ 5T. LUC1~ COUNTY. ~ FLORtDA 2 : ~ 't f i 's Fa i ~ I FURTtiER CERTIFY that 1 will comply with all other requirements of a legal resident of this State. ~ ' I FURTHER CERTIFY that I have no intention to return to my former domiGile, and f intend to remain in FORT ~ 1 ~ ~ PIERCE, SAI~,t.T,LUCIE COUNTY, FLORIDA, permanently. _ { ~ , ``~t,tt~tttt:?lj;,,:_-j~ . i ! ~ ~ 1..1~~ ~ 7 ~ x /~7'Z~ J//G.~.~t ` ~ ~ ~ ~ (Name) ~ . , ~ ; ~ ^r` ~ ~ : ' ' Bessie Mae b~ullin r : • : , . . . t~ <<7. - . . : e • ~ • • (Address) _ , ; , . ~ , ~ ~•C,~, 5wom to and subscribed before me this 7_f.h____- day of E~.~~r v , 19~~. ROGER POITRAS ERK CIRCUIT COURT ~ Notary Public By D.C_ My Commission expires , ~ (To be executed in duplicate and original filed with Clerk Circuit Court, and duplicate wifh Tax Assess~r.) 3 8ooK13~ 524