HomeMy WebLinkAbout2841 aN.~.~.
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~ D~cla~ation ot Domiclls and Citizenship (
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i TO TFIE STATE ANO COUNTY TAX ASSESSOR,
; ' ST. LtK1E GOUNTY. FtOR1~/1: .
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This is my decluation of Domtcile ac~d Citizenship tn th~ Stats of Horid~ that 1 am fili~p this day in aoootdai+os Md -
tn confcrmity with CMpter 222. Section ?42.17, Fiorids Statutes. ~
~ 1 was formsrlr a Ipal residw+t of ~ N. Jergey :
(C tY) . • (Stsh)
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~ 67 Charlee BtreeL ~„~,.r ~ haw charqsd ~r?y danWl•
a~d 1 rosided et
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to ~nd am and haw bN+~ a bona fids rosident af the Staro of Florida sinos . ~h d+Y ~
~ ~ ~02 Sout 2~th atreet -
~ JLne , 19_~, and~ I resids d
(Stre~t and Numbsr)
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~ORT M~E. SAiNT ~UCI! COUNTY, RORIDA
~ and this :tatanent is b bs taken as my dedantio~ of dtins~ship, adual Ipa! rssids~os a~d domld~~ in fh~ SfaN af Horida.
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i qnsert hero any pertinsnt fact:, wd~ ss ~le of propsry or bu:ineu, or rotinqui~msnt of ~mplo~ynwnt
~ at former domtdls, ~emoval of family to new domkile. purchase of hane, etc.)
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' Eatsblishing reeideno~ ' _
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; Xill appl~ for homeetead Nhen Booke open.•
~ . . . • fllEO ANO RECORDED "
Qerard xilienter the iirstgrade of echool ~r
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f i--~~~ 1964 SEP -2 AI'1 8: 54
# g+` ~<<.*'' ~z . . . ,
; ; ROGER POITRAS, CLERK
; - ~ ~ • > ST. IUCiE COUNTY. FlOR10
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~ i FURTHER CHtTiFlf Mut 1 rwill compiy wNh ail oth~ roquintr~ts af a isp~l rosid~nt of this Stat~.
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; ~ I fURTHER CERTIFY thet 1• have no tMention to retum to my fonner domldls, a~c! 1(ntend to re~riiin in FOR?
= i PIERCE. SAINT UI~IE COUNTY, FLORIDA, permanently. ~
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~ ~ b~?Sd wbsaib.d bsfor. m. this ~ day ot September , 19~
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's ' CiRCUR COURT NOtu~t PtIb11C
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~ f ~ c~-c-~t.~. TO C.C. My C.o~xnission ~xpir~s .
~ ~ 47 440 ~
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~ " . R• b. .~o.e+~rt~d 1~ drplis.~. aw~ .~t~al Ai.d wi~h tf.~1c CManc ~.w~, awd d~ea+. wMb T.oc 11..~.~or~
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