HomeMy WebLinkAbout2114 . ! % '-_'^~--'..~..r-_~_...-r--~-•.. _
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Declarallon o! Doiniclle nnd Citisenship ~
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TO THE 5TATE AND COUNTY TAX ASSESSOR~ ~
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ST. LUCIE COUIVTY, FIORIDA: . ~
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Thii i: my declaretion of Oomicfle •nd Citizenship in fhe Ststs of Florida that 1 arr~ fili~ this dsy in sooords
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in aonfomnily with Chapts? 222, Saction 222,17, Florids Statutes. ~
Columbus (ieorgia ~ ~
i was formerty a le9a) resident of ~
(CitY) ~ (State) i
~00 °rlmRose Road ~
snd 1 residad at - Howsver I have chanyed my domitile ~
- (Sttaet and Number) . ~
: 15 !
~ ro and aM and have been a bona fide rosident of the State of Ftorida since day of !
. Jurie 19 6~ and 1 roside at 206 3. 30th Stree~ti ~ .
' ' (St?eet and Number) .
I~ORT PldtCE, SAlNT LUCIE COUNTY, FLORlDA - '
and thi:~statement is ro be taken as my decisrafion of dtlzenship, actual ie~al r~idenae and domtcite in fhs Stars of Horlda.
pnsen here any pertinent facts~ sucfi as sale of property or bu:iness, or rolinqvlshment of employment
at farmer domicile, romovai of family b new domtale,' purchase.of home, etc.)
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Establiahing reaidence FlLE ¢~?D CO~~~ .
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_ 4~,~ : t r~* 1964 A~G 18 PW `I : O 1 ~
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ROGER PUtTRAS. CtERK ~
f~, i:•~ St. IUCIE COUNtY. ftORiOA
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I FURTHER CERTlFY that I will ovrnpty with
a!! other requirements ot a tega! iesident of this Stata. ~ j
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1 ftJRTHER CERTIFY that 1 have no intention to retum to my former domidie, and I intend to remain i~ FORT
PIERCE, SAfNT IUCIE COUNTY, FlORIDA, permanentiy.
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*f (Name)
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i , ~ ~ ~ I~tb~ 1Q. Thompecm
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• - ..'t. : = t (~kldress) ~
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: ~'~~ii~ 18 August ~ 6~ '
SMnor~ to and subsaibsd befom me this day of 19
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: . ROGER ~RRAf .
- ; . C R CO . Notary Publk
- ; ~ ' D.G. My Gommission expira " ~
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_ . ? ' R;L~`r reGE.~~~e1
~ ' (Te b~ ~x~artad in duplicat~ and ori~inal Al~d with Ci~rk Cirarit Co~tt, and dvp~ whl~ Taot AtwssorJ
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