HomeMy WebLinkAbout0543 ~
Decla~ation ot Domlciie and Citisenship ~ ~
148080 `
TO THE STATE AND COt;NTY TAX ASSESSOR,
Sl. LU~IE COUNTY, FtORIDA:
This is my declaratien of Domicile a~d Citizenship in the State of Florida that ! am filing this day in ~rdante a~d
in conformiry with Chapter 222, Settion 222.17, Florida Statutes.
1 was formerly a legal resident of __~.~_$sh]~$~_____,_ _ Kent~_k~
(City) (S1ate) ~
and 1 resided at ~ Flowever 1 havechanged my domic4le
(Street and Number)
to and am and have been a bona fide resident of the State of Ftorida since _ day of
Jut~e _ _ ~~q 60 and 1 reside at 317 No 18th
(St~eet and Number)
FORT PIERCE, SAIN? LUCiE COUNTY, aORIDA
and this statement is to be taken as my declarotio~ of citizenship, actual legal reside~ce and domicile in the State of Horida.
(inser~ here a~!y oertinent fads, such as sale of property or business, or relinquishment of employrx~e~t
at former domicile, removal of famify to new domicile, purchase of home, ett.)
Bmma Hall lives here and has homestead exemptian on her home:
Emma Hall is acting Cby consent of the parents of
Patricia Ann White) guardian of Patricia Ann White who
is entering the 9th grade .
Patricia Ann's father got sick just before they.left
from Kentucky, and Mrs Hall has the custody of Patricia until
Pat's father is well eno:~ght to travel.
1 FURTHER CERTIFY that I will comply with afl other requiremenis of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domitile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
.:~~:::rrr~J.~,-,
A~ RE~oaof o `1;~ ~ ~ ~~G;
E~ ~ YY A'
gT. t-V~~E ~ ~uN'~`~ 7 (Name) j ' . =
F~~C`.G~ - r' . ~ _ -
Em~a Ha I1 f ~
~~n ~ ~is~ t` ~ O~ ~ ~.'~-'J . r.
' ~3 r' ~ 3 Qg0 (Address) .•'v~
1.48 ~ ~z ~
i~u~ ~ ~VRY
Sworn to ~~~~4s~i1b~"liefore me this 30th day of ~uguSt ,.~q 66 .
ROQER POITRAS ~
CLERK ClRCUIT COURT Notary Public
gy ~.C. My Commission expires 6~
Qo b~ ~xecuted in'duplicaM ~nd original ~iled with Cl~rk Grcuit Cour~, and duplicat~ with Tax Ass~ssor.)
a°ooK 153 _ 5~
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