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DeGlaration ot Domic~le ~nd Cltizer~ship
TO THE STATt AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FtORIDA ~
This is my declaration of Gomicife and Citizensh~p in the State of Florida that I am fiiing ihis day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes
I was formeriy a iegal resident of ~1 I~~`~1 YO1~C
(City) (State)
$3'~5 '+~OOt~hBVeri Blyd However i have chan ed m domi4ile
and I resided at _ - g Y
(5treet ancl Number)
to and am and have been a bona fide resident of the State of Flor,da since _ day of
Septe~ber bs 69~ Sandia ~~enne~ Par~t St. Lncie
- - - . , 19- . , and ! reside at . - - - -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of ~lorida.
(Insert hsre any pertinent facts, such as sale of property or business, or relinquishment ot employment
at former domiciie, removal of family to ne4v domicile, purchase of home, etc.)
Establishing residence
- _ =~IL~D ; R~CORDcD
. Q~1C18~-~EL~-' Q 0 K
,.~i, ' . -~.~°~.~-~G~/
f ~5 o I;i,~ : 0 0
_ _ 1 ~~4 ~1)tu~','„S' ~~;!t
;,-i. ~Jt;l~ ~~v,~TY.
, ~r. .
('`C:~IUt+
I FURl'HER CERTIFY that I will comply with all other requirpmen~s of a legal resident of this State.
! FURTHEP. CERTiFY that I have no intertion to reTurn to my f~rmer domic,ile, and I intend to remain in FORT
PIERrE, SAINT LUCiE COUNTY, FLORiD~, permarently. -
' ~ u.
_ -
- (Name) ~
• Elias A. 5terling
f ~ : _ _ v _ -
~ (Address)
,
5worn to and subscribed before me tnis _ 9 _ _ d~y af _ _ ____~~~~r- , 19 ~ •
ROGER POITRAS -
CLERK CUIT COURT Notary Public
~ ~ _ D.C. M Commission expires
BY y
(~o be executed in duplicate and original filed with Clerk Circuit Court, and duplicate with 7ax Assessor.) ~
BOOK 1~~ Jc7~