HomeMy WebLinkAbout1251 ~'~W ' ' ~~r~. T : ~ v- it - ia - \ 1 •~.w ~
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' Declaratlo~ ot Domicll~ and Citisenshlp
13~295~! ~
TO THE STATE /1N~ GOUNTY TAX ASSESSOR,
ST. WCIE COUNTY. ftORtDA: ~ .
Thts is my declu~tion of Oomicil~ ~nd Citizeruhip i~ fM Stat~ of FlorJd~ thst 1 un filirp this day in aooorda~a and
in oonformity with Cfispter 222, Ssttion 222.17, Hotida Statut~s. .
I was formerty • legai rosident of R~tG 11RW Y~ tti i
(Ctb) lSt~ta)
and 1 ~ssided at Roc1G, Co lony How~vK 1 h~vs dwnqed my domidl~
(Streef Md Numbsr)
~o ~nd am and have been a bon~ ftds rosident of ths'State of Florida stnos 6t~ day of ;
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Oc tobe r ~ ~q64 , ~ te,~ a~ 140 Bst~~ LAae
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~ I~ORT MERCEy SAINT WCIE COUN?Y, RORIDA ~ •
and this atatement is to be taken as my dederotion of citizenship, ectusl lepal retldena arx! domidl~ In th~ Stst~ of florid~.
(Insert here any pertinent fads, such as ssle of propsrty or budn~ss, or rell~quishnNnt'of empbyment ~
at iormer domicils, removal of family to new domicils, purchass of iwrt~s, et~c.) ~
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Bstablishing residenCy ,1~~~~ ~
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cU+r . ~o,,~ ~ . • 196SfE~ -i AM11:23 - .
~ . , ROGER P~ITRA ,
~ • • " ~ S CLERK
= ~ST. LUCIE COU t
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I FURTHER CHtTIFl/ that 1 will oompl~r wMh all ath~r ~~qulnrt~nts of • ipal ~id~M af th~t~ Stat~.
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I FURTHER CERTIFY that 1 havs no ~Mentbn ta retum to my former domkila, and 1 lntsnd=•tp,~emaip in. f.ORT ?
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PIERCE, SAINT WCIE COUNTIf, FLORIDA, permansntly, _ _ , _ ' ;
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. Sr1c R Sproule !
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Sw~or~ b a~d wbscribsd bsfw. me thts lst. ,~y ~ Februar~ 19 65
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~ ROGER MRRAS i
. ~ CIRCUR OtlRT • - Notary Publk
~f? ~'"`'~'G O.C. Mr Comrr~lulon ~xpira
~ (Te i~ ~one~t~d iw d~licM~ ~d wioiwal f~i wilb CINk Cinrif Gw~, ~i d~lial~ wMl~ T~oc AtM~,~ '
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