HomeMy WebLinkAbout1243 ? ~ .?Y w ~ iJ~'~ a r -
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~ecla~ation ot Dornictle and Cltisenship ~
TO THE STATE AN~ COUNTY TAX ASSESSOR, . 132952 ~
ST. IUCIE COUNTY, FIORIGA: ~
Thi: is my declsratlon of Oomlcils ind Citizenship in fhs State of Florida that 1 am filinq this day i~ ~ooorda~a snd
in oonformity with Chapter 222, Sectio~ 222.17, Florida Statut~. . -
1 was forms?ly s legal resident of Clarksburg ~ hf.Vllgi~iA
tCty) • (St~») f
a~d 1 msidad at 1505 GOUld A~e. ~Ye ~
nqsd my domlcll~
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ro and am and havs been a bons fide resklent of the Staro of Florida sinos 20th day of ~
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~ MarCh ~ 19 64 ~ and I restde at 808 Asalea A~e. ~
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~ FORT lIERCE, SAINT LUCIE COUNTY, RORIDA • ~
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a~d this steteme~t is to bs taken as my declaretion of cltizsnshlp, actual lapal residenos and domidle in ths Staro of Horida.
pnsert he~s any peninent facta, such as sale of property or business, or relinquishment'of enlploymsnt
at fo~mer domtcile, ramovat of family to new domicile, purchass of horris, etc.)
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132952 . ~
. Iri flIE~.AND RECOflOED ,
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Estabii'shing residenc~ BQOK ~
. 1965 FEg - ~ ~ i' :
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- . . . ROGER POITRAS ~~K
ST. LUCIE COUNTr. FLORIQA
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" 1 RIRTHER CERTIFY that 1 wiil aomply witfi ~ll othsr nqul~emenis of • Ipal rosidsnt of thli'S~If~:""'•~•~ '
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I FURTHER CERTlFY that ! have no intentbn to retum to my former domWls, snd 1 intend to rematn in FORT
PIERCE, SAINT LUCI~ ~OUNTY, FLORI~A, permanentty. ~
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G~.r,... ; ti~+~~``'~ Ma~j '
.~r~ y+- . fti William R. Everitt Jr.
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~i~ . .`i, ` . n' ~ ~ (Addt~s3) 't,
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\"'s, ~i„~:~ ~ ' ! ;
~ ~ ~ ~ lst ~ ~ February 65 i
'ti~i~ro,pnd wbscribed before ms thb y 19 ~
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. R a~c romu?s f
~ CtRCUR URT Notary Pubik ' . ;
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' BY ~ D.C. My Canmluion ~xpins ~
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~ (Te b~ ~oc~a+hd tn dupticat~ snd eri~ieai fil~d wi1l~ CM~c Ci~adf Gwt, aw~ ~pKoM~ wMl~ Tax Aw~,~ `
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