HomeMy WebLinkAbout1759 i
Oeclaration ot Don~icile and Citizenship . ~
TO THE STATE ANO COUNTY TAX ASSESSOR, 1~53'79
51. lUC1E ~OUNTY, FlOR1~A:
This is my detta~ation of Domicile and Citizenship in the State of Ftorida that 1 am filing this dsy in aoootdante and
~n conformity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of _ Coecord New Ha~nashire
(Ciy) (Stats)
and 1 ~esided at - --`RFD i~2 ~wever 1 have chsnged my domk3le
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since - ~tb day of
Jaouaty ~ 19 66 a~ ~ reside at 723 S 7tb Street
(Street and Number)
FORT PIERtE, SAINT LUCIE COUNTY, RORIDA ,
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the Stab of Ho~ida.
(Insert here any peninent facts, such as sale of property or business, or relinq~ishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
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FlLEO AND RECOROgp ~
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Bstablisbing resiflence ~ss ~1' I 1~ 3; Zy
j4 ?y~ ~
ROGE14 P~17RA~`~ ~
ST. ~~~~E COUNTY~K ~
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1 FURTHER GERTIFY thst I will oomply with all other requi~ements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LI~G(,~UNTY, FLORIDA, permanently.
,~,5`,,rtiu ~t~~if~i
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' Ci~;•,S~~Y~' t:;'•
= r (Name)
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~c ~n,, ~ _ - ~ Bernard Ystsf ield
, l~~j . :..4, - ; : Q -
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. ~ ~ ~w ~ (Address)
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Sworn ~o qrid~wbsuibed before me this 17 day of ~p ~ 1966 .
~ ROG~ PORRAS
qFRK CUIT COURT Notary Public
_ gy D.C. My Commiuion expires
(Te b~ uc~whd in duplicat~ and ori~inal fil~d wifh Cle~k Ciraiit Coart, snd dupli~at~ with Tax A~s~or.)
s~K 145 557'
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