HomeMy WebLinkAbout1909 ~
Decl~ration ot Domicile a~d Citize~shlp
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YO THE STATE AND GOUNTY TAX ASSESSOR, •
ST. ltK1E GOUNTY, fIORlCA:
This i: my decluation of Domkile ind CiN~nship 1~ th~ St~t~ of F~orida th+~t 1~m filinq thb day In ~oc+ord~na a~?d
in aonformlty wifh Chapts~ ~2~, S~ction 24~.17, lorida Statuta.
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. ' ; 1 w~s fomw~ty • Ipd rosid~nt of . _ • ,
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and 1•~sided at Hovir~var 1, haw chan~ed my domtcii~
(Sneet and Numbs~) ~
; a~d am and hiw ~en • bona fids ~eiident of tha Staro of Ftorida :ina day of
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: . , i , a~ i ~~we ~
~ (Stre~t a~d Numbsr)
~ FORT LIICIE COUNtY, RORIDA
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and this statement is to be taken as my deciaratlo~ of ciNz~nship, actvai tepal raidencs and domidle in ths Stats of Hortda.
; pnssrt hera any pertinent fact:, such a: s~le of propsrty or bu:lness, or relinqui~me~?t of ~mploym~nt ~
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' at former domicile, romoval of famity to new domidte, purchase of twme, etc.) ~
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~ FlLED AND RECORDED ~ ~
; t~_Q~ia~:~er~:..800K `
9' S8 ~ a~' ~ ~
` 1964 AU~ 12 AM • - ~
•a;.~A r?~.~.~• r,`~:;
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; . ROGER POITRAS.CIERK~ • ~ ~ir' ) ~ ' ;
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S~. IUCIE CO NTY fQ~ ;
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. 1 FURTHER CERTIFY thst 1 will wifh '
all othK requi~emenK of a le~s! roside~t of thi: State.
i 1 FURTHER CERTIFlf that 1 have no intention to rotum to my forma~ domicjte, snd I infend to romatn in FORT
~ PIERCE,~i~11NT ~I.11C~1~ COUNTY, FLORIDA, permanently.
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i G4dd~ess)
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~ . Saworn ~o and tub~aib~d t»fan me this dsY of 1~
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ROOER ~OITRAS .
~ Notary Pubik , • ~
f 8'!I ~ D.C. . My Ga~xniuiar expi~es .
~ t~r. b. .x.cw.a M d~,pikM.. O~r ~ ww~,~ c~M~a~M cow~, a~a a~. ,~rM~ T.x A~......a -
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