HomeMy WebLinkAbout0945 .~r. ~I'M ~ + ?
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Oaclaration ot Domlail• and Cit~enship
.132'78'7
TO THE STATE MIO COUNTY TAX ASSESSOR.
S~. lllGlE COUN11f. HORIW~?: !
Ih1s is my d~du~tion of Domicil~ and Citi~~hip in th~ Stat~ of Florida that 1 am filinq thtt d~y In aGOOrd~no~ and
in cot?famtty with CMptsr 2ZZ. Sec~ion 22~.17, Florida St~tutK.
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I was formKl a i .Iacksonville • North Carolina
y e~al ~esid~nt of
(City) (Sta»)
433 Nelson Drive '
and I~3dad ~t .~bw~vw l haw chanpe~ my domWi~
(Stresf and Number) ~
b and am u~d haw be~n s bone fkis resident of the State of flaida sinos 24 day of '
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November , t9~~. and ~ rsslde et ~,p.q~o Z 8e,*.~,~q,~~ pensacnia Ra~
(Street and ~mbsr) .
l~ORT M~CE, iA1NT WCiE GOUNTY~ fiOR10A -
u~d th;: ttatenwnt it ro bs taken ss my declaration of citizsnship,. actual Is~aal retidenos aod domicile in th~ Stat~ of HoNd~.
p~sert here any pertinent facK, such as sale of property or busint~, or relinquish~nt'af emptoym~nt
at former domicil~, removal of family to nsw cbmiale, purchass of twme, ~tc.) . .
Bstablishiag residence
132'?'87' . ~ ~ .
FlIED AND RECOROED ~,,,..~'..'~",,,,,"3%'~,
IN • • BOOK ~ ~ ~ ~'a~''-..
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. ~ 1965 JaN 26 AM 10: 51 ~ :
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ROGER POITRAS. CIERK - ~ ~ ~ ~ ' =
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, ST, IUCIE COUNIY, FLORIOA . ~ ~ ~
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1 RJRTHER CHtT1FY that I wiil oomply witfi ali otF~ nquir~n~nb of a Ipal ~1d~M of thia Stat~.
! FURTHER CFRTIFY that ! have no intention to retum to my former don?WI~, ~and 1 intand b remain In FOkT ~
PtERCE, SAINT LUCIE COUNTY, fLORtDA, permsnently. ~
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- ~ • ~ David S. Sturg;t i
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<<<.~'ES'~Otn b ufd.wbstribsd bsfot~ rrw this ~ day of Jaauarv 1~..
ROGER ~
CLERK COURT Nota~ Publk `
df? D.C. My C~xr~Iuion ~xpi~ }
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: ' (T~ b~ ~on~d M~pNsaN awil ~ei~al ~Al~d wNM Cl~lc Ck~i1 Cowf, a~ ~M~M wf1U Taoc w~~~ .
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