HomeMy WebLinkAbout2293 Declaration ot Domicite and Citizenship 9
14~,~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in ths State of Florida that I am fili~g this day in accordanoe and
in conformity with Chapter 222, SecNon 222.17, Florida Statutes.
I was forme~ly a legal ~es~dent of _ Willimantio _ Conneatiaut
(~~y) (State)
319 valiey St.
and 1 ~esided at - However I have than~ed my domicile
(Sfreef and Number)
to and am and hsve been a bo~a fide resident of the State of Florida since ~ dsy of
" April , 19 66 ~ and I reside at 400 Ai7ro8o Blvd~ Fort St• Lueie
(Street and Number)
FORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to be taken as my detlaration of citizenship, actual legal ~esidence and domicile in the State of Hotida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
Parents moved to above address in January of 1965. I am and
~ill remain stude~qt for a few more yeara. f desire to make
Florfda the state of my legal residence and my pa rents home
the peananent address.
FflEO ANO RECOROEO
ST
RECORD VER F ED~~
~6 /~Y 3~ AM a ~ yy
~ 145~689
~ ~;O;;~M ~-OItRAS
~ CLERK CIRCUI7 COURT
~
1 FURTHER CERTIFY that I will aomply with all other requiremenri of a leyal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my form r d ' le, and I intend to remain in FORT
PIERCE, SAINT•~lU~1~ COUNTY FLORI~A, permanently.
~
* r' .
, ~ - OtW Marenin
' - ~ • „$~S
° . ~ (Name)
~ ~ - ~ .rjff .
'
r ~i'~~1 w f~ ~r l~7.0 N. Leroua
. 7:
' • FlagstafP. Arizona
~ ;iy ~ r •
sx{i;~•~ U. ~~t:~~:~~~~ (Address) -
- ~ f 1 1'~ • _
vJ.~~~~OC~ \ ~
~~wocn~to and subsuibed before me this day f •
- .
_ Mv Commtsston bcpfra~ October 7, 1966 ~
ROGHt ~OITRAS ~r
CLERK CIRCUIT COURT tary Public
By D.~. My Commission expires ~
- (Te b~ paaM~d iA dupliule and o~i~inal fil~d wi1i~ Ckek Cirwh Court, and duplkal~ whh Tac As~or~
SooK 146 491
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