HomeMy WebLinkAbout0548 _ .
Decla~ation ot Dort~icile and Citisenship 1433.03 ~
TO THE STATE ANn COUNTY TAX ASSESSOR,
Sl. IUCiE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in attordante and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of COlU1DbuS Ohio _
- (City) (State)
59 Chittenden Ave. . However 1 have cha ed m domicile
and 1 resided at - - - - ~9 Y
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since __17th_ day of
August 65 305 Sandia Ave.
- _ - - • 19---, and I reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of cit~zenship, actual legal residence and domicile in the State of Horida.
(Insert here any pe~tine~t facts, such as sale of property or business, o~ reli~quishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing Residencd--
. . . ~i REC ~oEo
- . ` - ~N~~~iili BOOK
. ~ ~ _ ~ ~ ~
~ i..' ~----a~-CO
, . . , - a~; ; . 66 MAR q PN I : I ?
` . . . _ ~ ~ : Roc~
43303
` ~ ~ FO! ~ RAS CLERK
~ ST. LUCIE COUNTY.
~ • .
~ ` .
~ - ~ ' FI.ORIDA
, ~
B
~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
~
I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT ~
E
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
. ~
. _ ,
- ,,::~:;ril;r:ij1 ;
- ~ , ~~~VOL/~i
• . J
G , (Name)
^ U'•h,j ^ l
% - ; Terry L. Hildreth
~ • ' •
~ , ` (Address)
• ~a- • :J -
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~ ~~~'~o and subscribed before me this 4tb day of ~rch ~q 66 ,
~ ~ ,
ROGER POIT
CLERK RG T OURT Notary Public
~
~ gy D.C. My Gommission expires
~
~ (To b~ ~x~cut~d n duplicat~ and oriqinal filed with q~vk Grwit Court, and duplicah wHh Tax Ass~ssor.)
~
d00K
~~f ° R 139 545
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