HomeMy WebLinkAbout2212 ~e~laration ot I~~mi~ile ~nd Citiz~nship
TO THE STATE AND CC:~NTY TAX ASSESSOR,
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Sl. IUCIE COUNTY, FLORIDA: y-~ -
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Tl~is is my declaration of Domicile and Citizenship in ihe Staie of Florida that i am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
Fritch outside of Texas
I was formerly a legal resident of BOZ ~e~--_-_ - -
_ - -
(City) (State)
Bos ?2 '
and 1 resided at . _ However I have changed my domiCile ;
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 14th day of
F~b 66 ?21 So 2nd street
- - - - - - - _ , 19---- - , and I reside at _ _ - -
(Street and Number)
FORT PIERCE, SAINT LUCIE CdUNTY, FLORIDA
~.,a tt,~~ e4afnmuni f„ t,A rat~P~ a~ ~ierlaration of citizenshio. actual leaal residence and domicile in the State of Florida.
(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 children in school
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- ~h,,i ' _ G~~. rv'' ``~pUNTY, ;
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1 FURTHER CERTIFY that I will comply wi9h ail 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 domi~ile, and I intend to remain in FORT ~
;
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
;,ts~o - ! "
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~ 'i' f.- ;
- ~ . - (Name) -
~ ~ ' Mrs. Kenrith Cranfill
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j ~ _ . . (Address) ~
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= ~ ~ 16th Feb. 66 ~
'~~'Sv+rom to and subscribed before me this day of , 19 • ~
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ROGER POITRAS '
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ERK CIRCUIT COURT Notary Public
gy D.C. My Commission expires
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~ (To be executed in duplicate and original filed with Clerk Circuit Court, and duplicate with Tax Assessor.) j
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BOUK ~38 _ _ 40~ ~