HomeMy WebLinkAbout1101 . - -
; Decia~atlon ot Domicile and Cltisenshlp ~ 132866 ~
; TO THE STATE AND C~OUNTY TAX ASSFSSOR, ~
~ St. 1t1C1E COUNTY, FLORIpA: '
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~ This is my decla~ation of Domicile and Citisen:hip tn the State of Florida that 1 am fili~q this day in aooordanos and
; in ao~formiry with Chapter ~22, Sectior~ 2?2.17, Florida Statutes. ~ '
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+ 1 was formerly a legei restdenr of partr~idge • Kentuck~ ~
i . (~iry) (St~b)
~ •nd 1 r~ided .r Rurai Route, Partridge my ~W~
a (Stres~ and Number)
ro and am and have been a bons fids ~ident of the Stats of Florid~ unos lSth day of .
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, May . 19 64~ ~ i~~ ~t 1211 S~ltmann Ave.
~ (Street and Number)
1'ORT MERCE, SAtNT tUCtE COUNTY, FtORIDA . .
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; and this statement is to bs taken as my declaretion of dtizen~ip, actual leyal ~esidenos anrJ domidl~ in ths State of Horid~. ~
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(Insert here any peninent facts, such ss ssle of property or bu:Iness, or relinquish~snf~of smpioyment
~ at former domtcile, removai of family to new domidle, purchase of horne, ett.)
~ . 132866
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~ tvew Dom~ci~e ~ E AND RECORDED '
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: - [96S J~iN 28 ph ~ 7
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F COUNRAS, C~~ ~
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~ . . , 1'. FLORIDA
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~ 1 FURTHER ~ERTIFY that 1 will oomply with all oth~r requlrerr~snri af a iepal resideM of th~s Sht~.
I fURTHER CERTIFY thst I have na intention to retum to mY formei domitile, and I intend to ~emain in FORT
PtERCE, SAtNT LUCIE COUNIY, FLCIRIDA, permanently.
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' Archie Johnson, Jr.
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Sworn to and wbsaribsd before me tfiit 28th ~y of Januar~ . ~ ~q 65 :
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` ROd~ rOfTRAS •
GLERK CIRCUtT COURT Notary Pubik
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; ; gY . ~.C. My Goewnission ~cpi~ ~
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= tTo b~ ~oc~whd M dupiisa/i aed ~i~iw~l filid wid~ C1M1t ~Cira~it Gw~, a~d ~p1ieM~ wMh Ta~t AM~~a
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