HomeMy WebLinkAbout2112 -
,
. ~
. ;
• d s
a .
Deciaration ot Dom~cile and Cltlsenship -~~8 ~'S8 ~
~ ~
TO THE STATE AND COUNTY TAX ASSESSOR, ~ }
ST. IUCIE GOUNTY, FLORI~A: ~ ~
This is my declaration of Oomicile and Citizenship in the State of Ftorida that i am filinq thi: day tn eooo?da~cs and j
in conformiy with ~hapro? 222, Section 222.17?. Florida Statutes. ~
Burlington North oarolina
1 was Formerly a leyal rosident of _ ;
~ (City) (Stats) #
. , ~
t
Rout e 7 8ox 610 f
- ar~d ! reaidad at . . However 1 ha~vs thanQad rny do~1~l~~ i
(Street and Numbe~) . ~
F to and am and have been a bo~a fide roside~t of th~ Stats of Fiorida :inoe ~'S day of ~
Augttet 6~ . ~
tq , end ~ ~e:tde a~- 2803 Oitrus Avenue
~ ~ ' (5treet and Numbaf)
I~ORT MERCE. SAtNT LUCIE COUNTY, RORIDA
. , .
and this statement is to be taken aa my declaration of ciNze~ahip, actual legal r~idenas and domiclle in ths Staro of Horida.
(Insert here any pertinent facts, auch as ~te of proparry or business, or mlinqvi~msn~ of employment
, at former domicile, removal of family to new domiale, purchase of home, etc.}
Establishing residence F'1LED AND_RECORDED
. !~'.--~.~~~-~se~r
~c~GOK
~ ~ 1964 AUG I 8 PM !r 43 ~ -
ROGER POITRAS. CtERK
t, ~r~*~, ST. EUCIE C
t~~~~lOA ~t~ .
• ~ : `y ~ ~~t; g
. la8'~~ -
'':,.:-x.~ ,
~ ~.i y "P ~ r ~~'ri:~ . .
. ;
~ i , _
; ~ _
~ 'f~'• ' " : •
~ ~ E L° ' ~ '
. . ~
. I FURTHER CERTIFY that I will oomply with '
atl other requirements of. a fega! ~~ident of this State.
1 FURTNER CERTIFY that I have no intentian to return to my former domitile, and i intend ta remain i~ FORT
PIERCE, SAINT LUCIE COUNTY, FLORtDA, permanently. ~ ~
.a~i ~ '~1l~2-~
' • . (~?a~)
~ ~ ~ . ~
~ ~ ` ~i ~ Betty ^~3~ove Trinidad .
, % -
• K _ .
~ ~•.'t ' ~ rr'-'~ r , --y`~ (Address) .
~ :
t': :k ~f''~;;.f ~ . ~ . . • ~
:r~'~_ ' ~ 18 Y ~ _ August y t96~
- •...~t~ €°,.dAd'subscrib~d before me thts da
; -
- .
ROGER fOiTRIlS
CLERK UiT COURT Notary PuWk
~ 8Y 0.C. My Commissian expires ~
i . ' ~I. A i
Ro b~ ~x~cuf~d in duplieat~ ~nd o~iginat Ai~d wAh CfKlc qrarM Co~et, and a
~ ' . . .