HomeMy WebLinkAbout0550 ,
Declar~tlon ot Domicife and Citizenshtp
. . 132585 ~
TO THE STATE MI~ COUNTY TAX ASSESSOR,
ST. LUCIE COUNTY, FLORIOA:
This is my deci~r~tiun of Oomicils and Citizenship in tM Stat~ of Florida that 1~m filiny this day in aooordanq a~d ~
in conformlty with Chapter 222. Settion 222.17, Florida Statuies.
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1 was forrtarly a le~a! resident of POrt Walton BCaCh Ptg?
. (Ciry) ~St~?~)
i~;~ ~t 114 Hu rlbe r t Ro ad ~~Ve ~
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to a~d am and have been a bona fids retidMt oi the Stats of florida sina lSt ~y ~
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k September 19 64 and I~~id~ at S ~ I
, , 5100 unset Blvd _ ~
. (Street and Number)
I~ORT N~CE, SAlNT WCIE COUNTY, RORIDA - ' ' ~
~~d this sfatemsnt i: to bs taken as my decta~ation of dtiie~ship, actual leQ~l residsnos and domidl~ in th~ Stil~ of Hotid~.
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pnsert hare any pertine~t facts, such as sale of property or butineu, or relioquishn+snt`of ~rt~playma~t
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at former domicils, removal of family to r~ew domicile, pu~chase of home, etc.) ~ j
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Estabiishing r~sideac~•~ •
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i32585
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FlLED AND RECORDED '
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1965 JAN 10: 3T • ;
16 AM s~'., w
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ROGER POITRAS. GIERK ~ '
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Sj. IUCIE COUNTY. FLORIDA 's r: ~ ' ;
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1 FURTHER CERTIFY that I will oompiy whh ail other requir~nri of a Ipal nsid~M df Nds Stab.
t FURTHER CERTIFY that 1 have no intention to ro~um to my former domicjle, ~nd 1 intsed to remain in fORT i
PIERCE, G~~~lC~ COUNTY. FLORIDA, permenentiy.
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~ . ~ eannie ~lathis , i
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Sworn ro and wbsaibsd before nk thls 16th ~y ~nea~y 19~~.
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f CtRCUR~OI~RT • Notary PuWk - .
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1Ti b~ ~aM~d iw d~+piiuh a~d e~l~i~l flMd wNl~ CMrk CM~eMM Gwt, and d~pliaN wMi~ Tavc A~a
o.R: 108~ ~546
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