HomeMy WebLinkAbout1229 ~y
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~ecl~ratton ot Don~lail~ a~d Cltis~~ship
13?2940
TO~iE STATE /W~ COUNTY TAX ASSESSOR,
ST. U1CIE COUNTY, FIORIDA:
Thit is mj? declintion of Oomicile and qtitenship in th~ Stat~ of Florida that 1 am filinq thls day in aooordano~ and
in ao~formi~y with ~hapte? 22?. Section Z2Z.17. Florida Stah~t~.
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1 was formerly a 1e9a1 ~~ident of ~ 1Karvland
. (~tty) . ' ~ {Stat~) ;
Rt 3 Box 105 8
and 1~ided ~t I~low~vK I h~w chanqsd my domidl~ ;
lStreet and Numbs~) ~
b a~d am and have been • bona fids rosid~nt of the Stah of Florida doos Zlat ~r ~
~ october ~ 64 '
• 19 ~ , ~nd 1 rosid~ at -~8Q9 Juanita C Paradise Pk
(StreN and Numbar)
fORT MERCE, SAINT LtK1E COUNTY, RORIDA •
and this statement is to bs taken as my decluetiw~ of dti~snship, actual Ipal residsnos and domidl~ in th~ Stat~ of Horida.
~ pnxvt hsre any pertinent facts, wd~ a: sate of properry or bu~neu, or relinqvi~Y~of employm~nt
at former ~domkile, removal of family to new domkile, purchase of home, e1c.)
~ ~ 132940 ;
~ Establishing residency i
~ ~ f~.ED AND RECORDEO
~ . . ~ IN....,~~~.Rsco~d800K ~
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~ c;~"....~o~;'--. ~ ~ - - ~ - . ~ 1965 JAN 30 AM 10: I7 ' .
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~ ~ ~ ; ~ ~ , ~ ROGER POiTRAS. CLERK
~ ` * ; ~ ' G : = ST. LUCIE COUNT~. FLORIOA
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1 FURTHER G~RTIf1f th~t 1 Will compiy wNh dl athK nqutn~rMnb of i Ip~l n~ld~nt of th~ Stab.
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i I FURTHER CERTIFY that I havs no intention to rotum to my former domicjl~, and 1 intend to mmsin in FORT '
~ PIERCE, SJ11NT lUCIE COUNTY FLORIDA "
, . Pern?anently.
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ROaER r01TRAS ~
_ CIRCUR COIlRT ' Notaty Pubik ~
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