HomeMy WebLinkAbout1890 ,__,..,,..,,p.,.,.-.a..
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Declaration ot Do~nicile a~d Cittzenship .
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TO THE STATE AND COUNTY TAX ASSESSOR~
ST, tUC1E COUNTY, FIORIDA: .
~ Thi: is my daclaration of Domicile snd Citizenship in the State of Florlda thst 1 am filtng this dsy in aaordsnoe and
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in confamity with Chapte~r 224, Section 222,17, Fto~ida Ststutes. ~
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, 1 wss forme~ly a leya! re:ident of ~ _
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and 1 rosided st ° • . However 1 have changed my domtule
(St~eet and Number) i
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ro and am and have been a bona fida rasident of the State of Florida slnce day of
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~ ~ , 19~, and I reside at ~aO~ '~•L
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FORT MERCE, SAINT LUCIE COUNTY, RORfDA • •
and this statement is to be taken as my declaration of citizenship, actual legal restdence a~d domidle in the State of Horida.
, (Inse~t here any pertinent facis, such as sale of propery or business, or ~elinquishment of employment
at former domicile, removat of family ro new domicile, pu~chase of home, etc.) •
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f11.ED AND RECORDED=.
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l964 Al1G I I PM 1: 54
ROGER POITRAS. Ct~RK
~ St• ~uc~E CouNtY. FLORIO
1 FURTHER CER?IFY thst I will ~p~Y wi~
all other requtrements of a legsl resident of thia State.
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1 FURTHER CERTIFY that I have no intention to retum to my former domitile, and t intend to remain tn fORT
PIERCE, SAINT LUCIE COUNTY, FLORlDA, permanently.
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• ~ . (Name)
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~ t~ ' > jzpL~ UWdress~
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~ 4fWqrn~O snd :ubscribsd before me thi: day of ~9~
ROGER tO1TRA5
C CUR OURT Notary Public
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8Y ~ D.C. My Commission expires
Qo b~ uacw~d in duplitat~ and ori~na ' t, ~ ~f, and duplicat~ with Tax A~ss~aera .