HomeMy WebLinkAbout1566 Declaration ot Domicile and Citlsenship ~
TO THE STATE AND COUNTY TAX ASSESSOR. 1~3g~'
51. LUCIE COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~es~de~r of . _ Evergrten _ _ _ _ _ N. Carolana _ _
.
(C;ty) (State) i
F
~
4
i
General Delivery__ Bvergreen P.O~ Howeve~ I have chan ed m domiGile
and I resided at _ - - 9 Y ~
Y
(Street and Number) i
~
to and am and have been a bona fide resident of the State of Florida since 1Q~11 _ day of
De~Ce~ber - i963 and I reside at _801__r1~_ 25th St.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actu~l legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
_ ~ y • ~
~
New Domicile
FIIE .AN REC Rg00K
.
;
. 0
- - . 'S6 t~A,R 25 PM !2 • 5 ~
~ - : f~=_ i433
~ ^ ;
. . . • R~JG£~ ; i,:.5. ~L~RK ;
. - `-:'s = S7. LUCIE COUyTY.
' c`: - FI.ORIDA `
j . . . ~ ; _
f . .
~ : T:"''~G=
~ "
~
~
~
~
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 domi4le, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- ~ Frdd Avaat '
~ ~ ' ' ( ame)
. ~ - ~
_ . . :
. . . ? ~ ~ -
~ ~ - . 'l =
- ; . ~ ~ (A ress)
~ " ~ - . '
~ ~i ~:~wti~..td'and subscribed before me this 25th day of - MarCh , ~q 66,
~ 'tililll•.
~ ROGER POITRAS
~ CLERK CIRCUIT COURT Notary Public
~ -
~
~ 6y D.C. My Commission expires
~
~ (To bs execufed in duplicate and originsl ~iled with Clerk Circuit Court, and duplicst~ with Tau Assessor.) F
'r''s
~ eooK 141 3fi3
: - - _ . _ ~
_ ~
_.~~:F~~x~. . - ~ .~~n..~~~