HomeMy WebLinkAbout1805 /~~~a•~c
~iaration ot Don~icile and Citizenship ~
TO THE STATE AND CWNTY TAX ASSESSOR, •
Sl. IUCIE ~OUNTY, FIORIDA: ~
This is my detlaration of Domitile and Citizenship in the State of Florida t t 1 am fili~g this day in acaordanoe and
in eonformity with Chapter 222, Section 22~.17, Florida Statutes. '
1 was formerly a legal resident of Omaha _ Nebraska
(CitY) (Stab) _
and I ~esided at 28 Burquist Dr. ~,,,,ever 1 have changed my dornidle
(Sireet and Number)
to and am and have been a bona fide resident of the Stab of Florida since 2 th day of
, 19
66 , and t reside at 301 So 213t street
(Street and Number)
( Temporary now- 1405 No 45th
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual lega! residenca and domitile in ihe Stab of Horida.
(Insert here any peninent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence '
ST~ LU~~~
CO E~ORD p
~ CORp yERjF
~
~
'66 s~,p 2g'c~~.
148'~ 9 ~ y3
8~
CLER ~~A f'ORRa _
K C~RCUIT ~pURT
1 RJRTHER CH2TIFY that I will aomply with all other requirements of a legal resident of this State.
- ' I FURr1iER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
; PIERCE, SAI~j~' ~,1CI~ COUNTY, FLORIDA, permanently.
j - ,~;i~1•. .t..;;;.~J,, ;
~ ,ti• ,~l; C
' . ~ e ) • OG'ii
= ~ = /
: . ~ ° - Name)
= u• ~ ~ i~' Lloyd Kyle Murray -
~ ~n= -..~`k: ' -
; .
, ' ~
~ ' (Address)
~ .i~r~-
.
Sworn to and subscribed before me this 29 day of September ~9 66
.
ROGER POITRAS
CIRCUIT COURT Notary Public
BY ~G~~~ D.C. My Commission expires
(To b~ ~x~cut~d in dvplicat~ snd ori~nal fil~d wf~h Cl~lc CiKUit Cour~, and duplicat~ with Tax A~ssor.~
a~oK 156 - : 2
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