HomeMy WebLinkAbout2598Der.:larotion of Domicils and ~tizenship
TO THE STATE AND COUNTY TAX ASSE.SOR, 8a~~ 28 MwE 46a7
~y $~r j,~pi~_000NTY, FLORIDA: a ~J .. V
Thh is my dedaration of Domldle and Citizenship in the State of FlorTkyaLl~E eeu~~FlA.~y
1-am thb In fiooordana and
in oonfomniry with Chapter 222, Section 222.17, Florida Statutes. w '
.. 1 was fom~srly a legal resident of____-~~ rt.~-------- ----.alb ~8r~1.
~-----------------, N laa«~l gY-------
and I resided at ___________________~~ xalachester AYe. ________-. However, 1 haw charged my domidle
~ (31rNt cnd b10mbM) M --- 1 .
~ and am and haw been a bona fide resident of the State of Florida sinos_______~__ 2~ ______________ day of
_-- Dg~Qmber _______-__--______________, 19__ ~, and i reside at __~Q ~~ S4~S_ AY9~s-------
--- Port st._ Luc>tie~ _Fort_ Pierce ___-__ ___St._ Lucie County, Florida,
---- (piy) ~-~_
` and this statement is b be taken as my declaration of dtizenship, actual legal residence and domicile in the State of Florida.
(InaaA h.n any pa.tMwnt faeh, aud~ a wb of propaely a biwitnaa, or rdk~quidrnant of ~nploymaM at forms danidb,
renaval of family b new dankilc, gwthw of hanai, e~eJ
Applying for homestead
- ~~ - ` -.~
.•
1! )2312 - : -..•:o~, : .
.~r~' ~~
~••
1962 JAN 29 AM II. ~~~'i.°~~~"nn - .'~,,'' .
ROGER POITRAS. CLERK
ST. lUC1E COUNTY. fIORIDA/~~~.
(-/
I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resicLant of this State.
1 FURTHER CERTIFY that I have no intention to return b my former domicile, and I intend to remain in
---~oZ`_t-P.~S.CGS-----------------------------• ----------------St~_ I±LiC3~------- - ~nry, Florida,
(ci<r)
permanently. ~ ~
-- ~-~-s~`'~i''~' - ---- -- --- -- -
(Nama)
_X Da~Lid J,_ P~ttersol~-_ _ - _ _- _ .
u-da..aa
. 62
Sworn to and subscribed before me this_______.29-- - _._-_-day of ________ January _ . _ _ _ 19__.
fto~er_ Poitras!_~lerk___________
ROGER POIT CLERK CIRCUIT COURT Notary Public
BY --- - - - ~ - _ ---------------- D.C. My Commission, expires - --
live M .saea~ i ~iieaN awl arfaiwa) fa.~ wM CMrk CLsdr CNA, aw/ ~Iira1. ~rilA Ta: Aaanacrl
s~co. n. •~cwcc