HomeMy WebLinkAbout1730 ~eciaration of Domi~ile and ~itizen~Ftip
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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. ~
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(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
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: ~.:;C~ _ RECOROED
F ~ fILEO AND
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? ROGER r'Ot i RAS. CLERK •
: ~
5T. LUC1~ COUNTY.
~ FLORtDA
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~ I FURTtiER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
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' 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. _ {
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! ~ ~ 1..1~~ ~ 7 ~ x /~7'Z~ J//G.~.~t ` ~
~ ~ ~ (Name) ~
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~ ^r` ~ ~ : ' ' Bessie Mae b~ullin
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• • (Address)
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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.)
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