HomeMy WebLinkAbout1473 i
OeCiaratio~ of Dotnicile a~d C~ttsenship 14~612 p ~
TO THE STATE AND COUNTY TAX ASSES~OR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declnrotion of Domicile and Citi=enship in the State of Florida that I am fili~g this day in actordsnae a~d
in conformity with Chapter ~22, Section 222.17, Flo~ida Statutes.
Ohi~
1 was formerly a legal resident of __"`"~'~a"° ~
(City) (State)
and I resided at ROU t@ 2 ~wever 1 have changed my domiCile ,
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 20 _ day of
August 66 121 Banyan Dr, Port St.Luc
, 19 and I reside at _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual leyal residence and domicile in the State of Flotida. ~
(Inse~t he~e any pertinent facts, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
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aNO ~~coRO~ ~
sT. ~ ciE coUNT~r R~;- '
RECORD VERIFI~p
Establishing resiaence '66 SEP 21 I~ ~ yQ
1486i2
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eiRCUr~ cou~
1 RJRTHER CERTl~f that 1 will comply with all other requirements of a lega) resident of this State.
~
.
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~ I FURTHER CERTIFY that 1 have no intention to refurn to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNN, FLORIDA, permanently.
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~ ; • t ~ i ~ " ~IG'!~~''~
~~Marion Barnshaw ~
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_ "r' j , : ~o~•rd W. Earnshaw
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~ 21 September , 19 66
~ Swor~` to aad subscribed before me this day of ,
~
f .
~ ROGER POITRAS
~ CLERK RCUIT COURT Notary Public
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BY D.C. My Commission expires
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(To b~ ~xscuted in duplicah snd original filed with Clerk Circuit Cour?, and duplicate witi~ Tax Ass~ssor.)
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