HomeMy WebLinkAbout1702~~ 3 ~~6
Thomas N. Brew
Declaration Sof~~o n~ici~e and Citizenship
TO THE STATE AND COUNTY TAB A.gsE$.~OR,
sT. IuCIa oovlvT~r. I+tioIUDA:
Thin is my declaration of Domidle and Citizenship in the State of Florida that I am filing this day in
accordance, and in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident oi_______-~ttabur~h __ _ _ __ __ Pennaylv__ania
sad I ivaiuexi ~.~_-_--: ~'•~i_ °i••`•'""" , ~•_ p"•~___ ---------- - However, I have cited my domicile
(~..s and i~va;~3
to and am and have been a bona fide resident of the State of Florida since------- -- --- --let-----._---------day of
_ 18 ~ and I reside at__ 18~ Se7caat~ Court~Port St_.__T•uQi e
-- (Strsat sad Nnmbar)
l~or t Piara a _~ ~ _ St . Lua i e __ County, Florida,
((1ib)
and this statement is to be taken as my declaration of dtizenahip, actual legal residence and domicile in
the State of •Florida.
(Insert base ass partiant teats, sncL ~ solo o~ _prov~nrebaao a,o~rte~~ni~hm~nt os omDlo~twat st
former domk3le. tumoral o? Tamils to sow do p
92174
FILED AND RECORDED
INQ~BOOK
196i FEB -7 PM 12:03
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1 FUIiTHEIi CF.IiTIP'Y that I wlll regLteir at my local address when the in+gistration hooka reopen.
and comply with all other requirements of s legal resident of this sate.
I FUETHER CERTIFY that I have no intention to return to my former domidle, and I intend to remain
?or't Piero• St. Lnoi• _Couats~ ~~~
y Lt,
(Natty)
Z'I~as X. Brew
(Adittw)
sub.cribo~, b~i'gi~. ~i~s .
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fr• b. ~.~.+ ~ ' .efetaet Yet .ds ~ ahdt amt aw dstlea/. ~ s~ sar..a.r)
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