HomeMy WebLinkAbout0248 O~ai~?~atto~ of Domicil~ ~d Cit~~nship ~
~ . 14'~~
TO THE STATE AND COUNTY TAX ASSESSOR, '
ST, ttK1E COUNZIf. FIORIDA: ,
O
Thh i: my d~cJaration of Domicile and Citjze~uhip in the State of Florida th~t I am fili~q this day i~ aooordaeia and ~
in aonformiy with Chapte~ 222, Ssction 242.17. Horida Statuta.
~ ~ was ~orm~ty a ~.qa~ nsid.nt oi ~unington L. I. N Y
Kih) ~ (Sta»)
and i rosldsd at 7S Lodge Are, . Howsver 1 hsw dwnqsd my domkil.
~ (Shaef and Numbar)
to and am and have baen a bona fide msident of ~s Stataof Florida since ~th ~ day of
~ Rt a. ~
Au~ust ~q66 a~ at Hibiscus. Rd Boac 53
. .
. (Straet and Number) ;
liORT MQCR, SAINT LIJCi~ COUNTY. RORIDA ~
and fhis statsment is to be taken as my dedaratio~ of atirsnship, actual le~al residenoe and domicile in ths State of Florida.
qnsert hero any pertinent facta, such a: ssle of propary or busineu, or relinquishment of employms~t •
at f~ormer domicite, romoval of family to new domicile, purchsse of home, etc.)
8atsblishing r~sidence
_ -r.-- _
8ntering gathleen C~eary in ilth grade of acbool
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6fi At~r 22 PN 3:55
' 14'7888
~ _ Roc~~ ~o~~~~s
. - ~ ~LERK .CI~2CUiT COURT
i FURTHER CERTIFY that I will oamply with all other roquiremsnts of a le~si rssident of thb Stata
I FURTHER CERTIFY that I have no intentian to return -to my former domicjle, and I inte~d to remain in FORT
PIERCE, SAINT WGtIE C~[V~7Y, FLORIDA, permanently.
s..a~~iii .
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~''v ;•:;yJ ~ - (Name?
; «r~~. ~ • ~o-~~~ : Thomas clearq -
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~~o ~end'subscribed before me this day of 19
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Roac~ ~an?s
~ ca~cwr Not~~y ~,w~
By . D.C. My Commiuion expiros
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(T. b..oo.w~d b~ duptie.l. «~a e~i~in.~ f~d whb c;Melc cirwh couA, .nd d~. wii Tax A~......a
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