HomeMy WebLinkAbout2878 - Declaration ot Domicile and Citizenship ~
149~£~9 ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCiE COUNTY, FIORIDA: ±
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This is my detlaration of Domicile and Citizenship in the State of Florida that I am fiting this dey i~ eccordante and ~
~n conformity with Chapter 222, Sectio~ 222.17, Florida Statutes.
1 was formerly a legal res~dent of ___Vall~ Streara New Yp.~ _
(City) (State)
64 SuDSlt R08d , However I havecha ed m domicjle
and I resided at - - - - ~9 Y
(Street and Number)
to and am and have been a bona fide resident of the State of florida since 4__.- day of
June 66 Rout e 2 Box 5372, j-akewood
, 19 and 1 reside at
(Street and Number) ar
FORT PIERCE, SAINT LUCIE COUNTY, KORIDA
and this statement is to be take~ as my declaration of citize~ship, actual legal residence and domicile in the State of Horida.
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
Establishin~ residence E~~
~iufv ~NO ,
WciE c~~Rn~ou .
RECORO dy%~
; 33
'66 OC~ 26 AM 10 g9
1494
~LERK C RCUIT COUR7
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I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of thia State.
I FURTHER CERTIFY ihat I have no intention to return to my former domiti~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ?
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- . . . _ (Name) .
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. Christian , Wm. G.~ Tr.
- (Address)
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Sworn to and subsc~ibed before me this 2b day of ~tOber ~ ~q 66,
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- ROQER POITRAS .
CIRC IT COURT Notary Public
gy D.C. My Commission expires
(To b~ ~x~cut~d in duplicsh snd oriainsl filed with Cl~rk Grcuit Court, snd dupliu» with Tax Ass~ssor.)
600K 15~ PACE 4 77
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