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~~!, 57 fA'E 363
Dec1aratiOll of Domicile rs.~fy, fL A.
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TO THE STATE AND COUNTY TAX ASSESSOR,
...
ST. LuCIE COUNTY, FLORIDA:
This is my dedarat.lon of DomkU. and CiUaen.h!p in the State of Florida that I am filinlr- this day in accordance
and in conformity with Chapter 222, Section 222.17, Florida statutes.
I was (orm\!rly a legsl rC$ident of
I'ort Monnouth
(City)
New Jersey
Stale
an 1 I resided at
44 Creek Road
11:>wever, I have changed my domicile
(S!reet and Number)
10 nnd nUl and hl\Ve been a b;:ma fide re~ident of the State of Florida si',lce
1st
day 01
April
19 62. and I reside at
155 .solaz Ava.
(Steet and Number)
k'~RT PIERCE.. SAINT LUCIB COUNTY, FLORIDA,
and this ~tatemcnt is to be taken as my declaration of citbenship, actual legal residence and domicile in the State of Florida.
(In!lert here any pertinent facts, such as Iloile ot property or bUJlineSB, or relinqui.shment of employment
lit former domicile, removal of family :J new domlcle, purchase of home, etc,)
Applying for homestead
11.3381-
f\ltO ~NU RECORO~\) v
\g o{Udal~ IUG!\
\901 fEB 2 \ PM 'J. 57. /;
O\1R~S,CL~R'r\ ,.il
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I FURTHER CERTIFY that I will register at my local addreu when the registration books re{)pen, and comply
with nil other requirements of l!. leisl residl;;ut of this St.aU.
I FURTHER CERTIFY that I have no intention to return to my fonner domiclk, and I intend to remain in
FORT PIERCE, SAINT LUCIE
COUNTY, FLORIDA, P"""'''ZauR e ~ IL
- (Name) (;l
Frank c. rteinecke Jr.
(Address)
~\\'orn ~o !lmI subscribed b-.ofore me this
21
F.eb~_, 19 63
,day of ___-
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ROGER POITRAS'" . "" . :....;'>, : 7', '.
~r, . RK CIRCUIT COURT ',' (:;~~~",ii'aU,'t.";,,,,)),{, .
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~ ~ -Go. 4 A~: >/, 4':<~i!~'~ g ~y Comtnlmor ~~Irea
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(To be exei:uted In duplkate and ~"I~.:.t;l~ i 1i1~h Ckrk Circuit Court, and dupUuk with Tn ~)
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Nota..ry- PubI~