HomeMy WebLinkAbout0701- I~ecclaration +~f Domicil_t ~tnd C~tizenshi~
tl . P,. `
TE ND COUNTY TAX ASSESSOR, b~r1K ~~ YALE
To THE STA a .
3T. LUCIE COUNTY, FLORIDA: ~~ - JT, i_!!~IE C~:l!N ~ ~+ ! i-..A•
This Is my declaration of Domicile and Clt;zenship in the State of Florida that I am filing this day in accordance
and in conformity ~•ith Chapter 222, Section 222.7, Florida Statutes.
I was formerly a legal resident of Long- Island, New York
[City) State
and I resided at ~ S~ P i n~•: a v ~t r A A t _ However, I have changed my domicile
[Street and Numbed
to and am and nave been a bona fide resident of th= State of Florida since 5th ~ „~;; of
January ~_. I9~~ and I reside st .Route 4 fox 438. Ed•~8rds I~
[Street and Nurr-ber)
E~ORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, -
and this statement is to b. taken as my declaration of citizenship, actual legal residence an3 domicile in the State of Florida.
[Insert here any pertinent facts, such as ssl° of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile purchase of home, etc-)
Have beer in the North onvaeation
Entering Eoy ~.~. rriedman in 10th Orade
• .~ . ~-~.
.. :-
.n. J
l~ O 0 RECDRD~D
P,~ ca-_~d-BOOK
~.
1952 iil',i i 4 Py !~; t ~
ROG ~ ~ COUtRA F' GRID~ ~~b~
ST . LU ,f ~`"
Q
I FURTHER CERTIFY that I wi;l register at my local address when the registration books reopen, and comply
with all other requirements of a legal resident of this State.
~'~~F FURTHER CERTIFY that I have no intention to return .to my former domicile, and I intend to remain in
N'OR~~'IIyBQE, 'SAINT LUCIE COUNTY, FLORIDA, permanently, /~
• ~-- C/
Y . - /~ t
. -+ - ~ [Name) ,
c
~ ~~ ~ '?.. Milton w. Friadman
14 November is 62
Sworn to~ and s+abscribed before me t;iis gay of -
R~%CER POl'iRAS --------------------
~~]] CLERK cj{iCUIT CCOURT Notary Public
3y _- ~a~~ /L__///'~/~o.~. D.C. 'qty Commission expires
[Ta Z•e e.Xecuted in dupllcat3 and origtn~l flle3 with Clerk Circuit Court, and dupt[cate with Tex Assessor]