HomeMy WebLinkAbout1085O.R. ~~ FAts~t~
Dt-clarati~n ~f D•~mici a and Gatucna~.ip
TO THE STATE A,'YD COUNTY TAX AS91e~SSpR,
3T. LUCIE_ COUN'T'Y, FLORIDA;
Thin is my declaration of Domicile and Citizenship in the State of Florida thst 1 am filing thLs day In accordance
and in conformity with Chapter 222. Section 722.17, Florida Statutes.
Mont a ztura
I was formerly a lega~. resident ot_ [City]
State
Virginira 4~D4W ~ ira le
and 1 resided at
(Street and Number]
to and am and have been a bona ilde resident of :he State of Florida sines
N ov enlb e r
Ga.
19 ~2 and I reside at
However, I have changed my domicile
19th day of
2G9 Gardeni® Ave.,
[Street and Number]
FORT PIERCE. SAINT LUCIE C.`OUNTY, FLORIDA,
and this statement is to be taken as my declaration of citi2~nshlp, actual legal residence and domicilt in the State of Florida.
(Insert here a~ly pertinent facts, such"as s31e of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, ete•]
Entering Shirley Jean in t he 6th ~ rade
~ J'oiznnie in Lhe 5th g rade
1~0~10
FlLE .A-~'~enoK
IN
1962 NOV 23 PM 2~ 40
`'`'1~.••~~~~ ROGER POITRAS, CIERK
~~ .•~,~U`";~~~;•.$.T. LUCIE COUNTY. FIDRID~~
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I FURTHER CERTIFY that I will register at my local address when the r~Sistration books reopen, and comply
with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to re turn. to my former domicile, acid I intend to remain in
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~' ~`~^
(N ] `~ (/
Meg. I.awrenceayne
(Address]
- 2g November 1962
Sworn to and subscribed before me this Say of
,5 ~:/:yF , i.
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ROGER POITRAS ;, ntV•' •~ ~__ - __
CLERK CIRCU COURT ~(ti;-~~'~ ~~:~ ;t,'• Notary Pubic
3y _ _ - ~C~ ~. • -., ;•3.ty~,•(`~i'~tis8!on e~-pires_
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[To be execute' h: t;npifrate sad vrigiasl ftled.~~~'C~~,)~`t~ert, sad duplicate with Taz Assessor]
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