HomeMy WebLinkAbout0226 ~ 9
~eciar~tlon ot Don~icile and Citisenship 14~~4
TO THE STATE AN~ ~OUNTY TAX ASSESSOR,
Sl. LUCIE ~OUNTY, FIORIDA: . -
This i: my detla~ation of Oomicile and Citize~ship in the State of Florida that 1 am filinq this dsy in aooordanas and
in ao~fomnity with Chaptsr 22Z, Sectio~ ZZ2.17, Florida Statutes.
1 was formeriy a legal ~eside~t of Buf falo ~ NeM York
~~ity) (Stat~) -
and ! rosided at 200a PBrk 1lveDUQ . However 1 have chan~ed my domidle ~
(Straet and Number) ~
ro and am a~d have been a bona fide ~esident of the State of Floriaa since day of
~nly ~ ~q 66 ~ a„d ~ rsside at 604 N. 6tb Street
(Street and Number)
fORT MERCE, S~INT WCiE COUNTY, RORIDA , ~
and this statement is to be taken as my dectaration of citizenship, actual legal residenos and domicils in the State of Horida.
(Insert here any peMinent facts, such as sale of property o~ business, or relinquishment of empioymant
at fomner domicile, removal of family to new domicile, purchsse of home, etc.)
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TO PLACB CHILD IN SCHOOL~ -
Helen 1~larie Burna 16 yrs.
RIl~E9 ANO R~~~R~,
ST. LUEl~ CO Y
RECA .D V~R~PILO
~ ~ 14'?'S'74
~i pjt6- ~i ~ i : 38
~
~ -
~4~E.~ i~OiTR:.S ~
CIERK CIRCUIT COURT
I RlRTHER CERTIFY that i will aomply with ail other requirements of a ie~sl ~esident of ihis State.
1 FURTHER CERTIFY that 1 have no intention b retum to my former domiGle, and I intend to remein in fORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) Francis P. Burns
604 N. 6th St., Ft. Pierce, Fia.
~ (Addressj
,,<<t~tr.ti:;;,j
I; .
V~ ~ C ~ _ ,
v 22nd August 66
•v~t'• ~3~i~~d subxribed before me this day of 19 .
V :
D~ '""%i ~ 1 ~i ~O :
~.j~'~~'~j,-:.~ s S _ .
i-' i, • '"',-i~,~ COURT Notary Public
: ~ _ •1
. i. - r' .
~y ~ D.C. My ~ommission expi~es
~'r,~t%1:lfftitlSl ~ «
Re b~ ~nevt~d in duplicaN ~nd orl~inal fil~d wi~h CINIc prwit Cou~t, and dupliah wilb Tax A~or.)
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