HomeMy WebLinkAbout1161ST. l.UCfE COilNTY, FI
Declorotion of Domicile o~
TO THE STATE AND COUNTY TAX A88BSHp8,
- 3T. ?sr~T~ COUNZ'Y~ FLO>t1DA:
This is my declaration of Domicils and Clti:esuhip in~ the
accordance, and in conformity with Chapter 222, Section 222.]
I was formerly a legal resident of_~;:~,pXp~pyLg..__~.
_ (Cib)
auu I iveiu~xi ~.~-- -- ---- .i.15~--EotLh-~aasraetJ-~enna---~
(St:wt sad Nambes)
to and am and have bees a bona fide resident of the State o!
------AltobwC-------------------------. 18_-6Q-, and I reside at----fls
Fort Pierce St,
ccia~
and this statement is to be taken as my declaration of dtizen
the State of Florida.
(Insert ~~ anY Aertinent tuts. snch as sale ~ party or br
former domicile. remoeal of tamil~ to .new domkfle, pnrehaN oC
Applying fos~i hbmsetead
Q~ f1`~'~
FI~E~ AND RECOR~QO
_~ _ „pOK
1`' a~~"J`~`~ " ..
CIE~.K
n1T~~1s. ~~
S-,. RUC
I FLTIiT:IEP. CEP.TII?'Y that I viii :cjsioi~ci st mr :~: ;
an(i comply with all other requirements of a legs! reridant of t.'
I FURTHER CERTIFY that I have no intention to return
~-----------F-orb-------Pia1'~~--------------------------------------. 8t .Luc
(ctts)
permanently.
~~tii
Sworn to and subscribed before me thia__-~_____-day o!
.~~aua_rg----------------------, A. D. 196__.
_~1zr]c__ni~i>csuit Co
(To be ezeented in dnpliate and original iilsd wlih Qerll G`Ireo
awn Buoo1• ('o.. Plint Citf. Fla.