HomeMy WebLinkAbout07482 X39
Declorotio T~o~~I~omMicile~~bnd Citizenship
TO THE STATE AND COUNTY TA% ~~;SES.gOR.
aT: T~TCSE COUNTY. FLORIDA:
This is my declaration of Domicile and Cltizenahip in the State of Florida that I am fllin~ this day in
accordance, and in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of____C~_-~~N _________--------------- __11EST_VIRGII!lIA_-__-•
(G1ty) -------------------~ - (8tate)
~ rn4~ n=i_ na .sr•~ ?~j~~ lI_-.m~vne• T ~er~ ••1+••••~-r•r~^.R!' t~ATYliwiln
anct t P`e8ldea at . lau~~i ~..-- .. ---- ........... ....... - ~ ----__ _
(Street and Number) r - - ~ro--
to and am and have been a bona fide resident of the State of Florida since 20 -_._-___ day of
_ -_,-_--February-_-.._-___-_____..___, 19~ , and I reside at.________-_____l47•-Prime__Vi$ta__Blvd. Port St.
(Street sad Number) ~1I~1$-----
1!~ort Pierce St. Luoie __~„n,ty, Florida,
------------------------------------- --------
cc~s~)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
former domicile remo al o! family tho ne dom vile ~pnrchue o1 b m~. o~relinq~tlshmeat of emDloymaat at
~i~b~.-
FILE ~1ND RECORDED
!!~ .._1~D~K
;,t;;;ER p01Tf~~S, CFF''
S.. LUCIE COUNT1f, FLC~.:. A~
.
`, `•
~ .
- L: ~.
_
- '!`
•., ~ . ~,. 1 eddro~a ml,p., the rwgiatration books reopen,
i :-1:::~1~f-.~:1 (;; n~, K~i~i ~+I i-iaT. ~ witt Pr~ii+~.cY a~ aia- .a.: :.. -
and comply with all other requirements of a legal reaideni; of i:nis slate.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
)Rort Pierce St. Lucie _~~,ty, Florida,
m--------- -- - ~ --- -- ----- --------------------------- ------- --------- ---- -
(cjt~) yy ~•,
permanently. ~ (' `__ ~.-.~!!~---~-------- ----------------
(Name)
xaymond E. Hi:ilcle
--------------------------------------------------
(Address )
Sworn to and subscribed before m>'t'lt~,,___ 17 _day of
,,
~:.• -.
'••• 61
•.
_January --~~
_~__-__-_ _________________________ ~ c- -~__L .
_ i
-
~ A
. I . • ~- ' •'Y'
~ / `
No 1?ablic S - atl~a-
My Commission expires__-6,~~~~~.-,.~.~'~ ~,--_~~_
- ~.
(To be executed in duylicite and ~ vtiRioal Algid with Clerk Cireuit Coact, and duplicate with Taz Assessor)
ttr,v~ao yucD1~ t'o 1'Idnt l•Ih. Fle.