HomeMy WebLinkAbout0186 TO THE STATE ANO COUNTY lAX ASSESSOR, ~~s'16,.7I
5~, lUClE COUNTY. FLORIDA:
This is my declaration af [~omiuls and Citizenship in the Stare oi F?orida that 1 am fil~ng this day in aoco~danca and
~n co~formiry with Chapter 22Z, Sectio~ 222.17, Florida Stat~tes.
t was forme~iy a legal ~es+de~r ot _ ~reznwir-h New ~ Jersey
(City) (State;
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6 Dglawar2 AYe. - - Flowever 1 have changed my domiGle
and 1 resided at _ . _ _ _
~"~t~eet and Number)
to and am and have been a bona fide resident of the State of Florida since _1S.~_. day of
_ _November,~ ~q 66 , and i reside ar 3432 Abbott Street !
(Strest and Number) !
t
FORt PIERCE, SAINT LUt1E COUNTY, FLORIDA
and this statement is to be taken as my deciaratio~ of citize~nship, actual legat residence and domicile in the State of Florida. i
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(lnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former dornicile, removal of family to s~ew domicile, purchase of home, etc.)
Bstablishing residence
fntering t~ro children in High school
~~D AND RECOR~Eb i
- ST, LUCIE COUNTY, F t
RECORO VFRIFIEO~'
'66 3 PM 2 ; 2s
14~ss,~
'=O.~i_A, ~~Or7RAS
CIERK CIRCUlT COURT
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1 FURTHER CERTIFY that 1 will comply with all other requ~rements of a legal resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domic~fe, and I intend to rema~n in FORT
PIERCE, SAIN~T, LUL'IE COUNTY, FLORIDA, pe~manently.
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. ~ ~rank ~~iu~e
. s' , ' ~ ~,~~~.~1.~!~l•~p~ i:C~iZGLt~~.
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- % ~ - Annabelle Bruce
i,~;.. , `
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~`'~=Swarn to and subxrib~d before me this . 3rd day of N~vember ~q E6
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ROGER POiTRAS ;
~CUIT ~OU~ Noiary Public ~
_,l/
gY CO O.C. My Commission expires 1
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(To be ~xxuted in dupfiwte and originst fiied with tlerlc Grcuit Couri, snd duplicaM wiH~ Tax Assessor.) ~
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aooK158 PACE }
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