HomeMy WebLinkAbout0610 DeCl~ra~tio~ ot Domicile e~d Ci+t1sar~ship
TO THE STATE AND GOUNTY TAX ASSfS50R,
Sl. LUClt COUNIY, FLORIDA:
' i m detlaretion of Oomici e and Citiienshi in the State of Flo~ide that 1 am filing this da / in aco~rdanoe and
Th~s s y ! p
in conformity with Chapter 222, Section 222.17, Florida Statuies. ~
I was formerly a legal resident of - _.~u~s Wentchte Washington
(Ciry) ' ~a~~
and 1 residad at _ 735~ Wentchte Ave. Howeve~ 1 have changed my domidle
(Street and IVumber)
b and am and have been a bona fide resident of the State of Florida since 30th day of
actober , ~qb6 , and I ~eside at Kumbline Klin Aoad
(Sheet and Number)
FORT PIERCE, SAINT LUCIE COUNIY, RORIDA
~nd this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile,.rwnoval of family to new domicile, purchase of home, etc.)
Bntering Frances Townsend in the 8th grade -
" Hal ~dward in the Sth ?rade
" Jane Louise_ in the 2nd grade
~fi9 A~1D RfC~~' i
'r S?• lgCtE COUNTY. Ef.A.~;
R~C4R0 VERIFIEp
'66 NOV I q AN 10 : 03
~ - -~49903
~ ROGER :-p~TRAS
6LERK CIRCUIT COURT
{
1 FURTHER CERTIFY fhat I wil) aomply with al) other requiremenis of a legal resident of this State.
;
~ i
I FURTHER CERTIFY that I have no intention to return to my former domiG~e, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY,-FLORIDA, permanently.
~
,,`~ti1fl:illl:;;..
~l i ~ - (Name)
: Howard Townsend
G • . . ~ _
• J I a' _
' ~ ' _ -
~ ' _ - " - Wddress)
i • _
~ ~ ~~v ~ -
~ ~ j:,~~~;.~ ~ 1
d±~_ _
~ •~~`suburibed before me this day of NnvPmhPr , 1q_fib...
~ ~ . ~':~~~t;?''~~~ .
~ POITRAS
- CiRCUR URT Notary Public
~ a.-~..~e~ ~
e D.C. My Commission expires
~ (To b~ execuMd in dvpliuh and oripinsl filed with Cle~k Grwit Court, and dupliuh with Tax Ass~ssor.)
OR
eooK159 P~~~ ZQ
~
- 2 - _ -
~~~~~'s ~ ~-~a-, _ t `
~
R~_
- x`~ , :r
_ _ -
_w: ~
„ - . _