HomeMy WebLinkAbout1775ST. LUCIE COUNT, FIA.
Carl He1ns
Declaration of Domicile and Citizenship
TO THE STATE AND COUNfiY TAX ASSESSOR,
ST. LIICIE COUN'T'Y. FLORIDA:
This is my declaration of Domicile and Citizenship in tha State of Florida that I am tllin~ this day in
accordance, and in conformity with Chapter 222, Section 222.1?, Florida Statutes.
I was formerly a 1e2a1 resident of______~ _]QIl~4___---._____~_---------------------, _-----CALIl~'OR,AtIA---------
(Cib) (8tats)
1360 8?th 8t. - However, I have changed my domicile
and I resided at---- - ---- ----------- -______------------------- ----------- -- ----
-- (8t:+st aid Nambas) -
to and am and have been a bona tide resident of the State of Florida since .-_.-1st __ _ -___-___ dsy .,f
Deoembir ~ _ 18__80 and i reside ac-_.__ 113_ Estia _I,ane~__Port _3t._-_Iuais ___-
- (Scat sad NumMr)
lbrt Pierce St. I.uo ie - County, Florida,
and this statement is to be taken as my decLration of dti:enahip, actual legal residence and domicile in
the state of Florida. ~ cr
(Iawrt bars aa~ partinant tads. such as sale of ptov.rtn~aas ~s~~ni.Lm.at o~ .mpl.ym~c at
forms domicil.. rsmo~.l of tamilf to aw dorm p
~lJ
F~! Ee aNO,R.ECOe.flcc
,~- -. _ ~K
~g~l FE8 -9 AM p•2~
ROGER POITRAS. CIfRK
St. WGt C~Wry, FIOR~o:~
. ~ . - ,- .
-,_~~ ~':
~~.
and complRy~R CER~eTIFYI"'e9uirem~tallof awl e2~e1 i esid~t of thud ~~ hen the re~iatration hooka reopen,
I FURTHER CERTIFY flat I have no intention to return to my former domicile. and I intend to remain
is ?ort Pisrc• _______, St. Laoie _~~,~ F1~r;~,,
cc~) ~ '
permanentb• ~~__._._,_.__
'~ cxa~.
Ciirl Heine
Swo~~anc~.;
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(Adds.)
l~edcn ms tbis..._..~~~r ci .
.,
s~:.~'s _~ A..D. 19.61
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~l..t twa way amt c~ hod, .ad . wlth Tss .s....erl
sa... ssDas a.. r+.u cw. i~
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