HomeMy WebLinkAbout1439 Decla~ation ot Damicile a~d Citizenship ~ {
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TO THE STATE A1VD COUNTY TAX ASSESSOR. ~
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Si. lUC1E COUNTY, FLORI~A:
This is my ~iecla~ation of Domicile and Citize~zhip in ths State of florida that 1 am filing this dsy in acoordance a~d
~n oonfo~mity with Chapter 222, Section ~222.17, Florida Statutes.
1 was f~rme~ly a legal resident of ~QLd~n_._~n~..iana _ Ind~ ana
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and 1 residec, at $t „ 2., However 1 have changed my domic,ile ~
(Street and Number)
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to and am and have been a bona fide ~esident of the State of Florida since 29tb day of
November ,~q 66 , a~ ~ reside at . 1612 Oran~e Avenue _
(Street and Number)
fORT PIERCE, SAINT LUCfE COUNTY, RORIDA
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and this stetement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida. ~
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(Insert here any perti~ent fatts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, pur:.hase of home, etc.)
Entering Mazk Hurst 6th Grade ~
~t Teena Hurst 6th Grade
't Robin Hurst Sth Grade F~LEO ANO RECORDEO ~
ST. LUCIE COUNTY, FLA. ~
C0~0 = RIFIED
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66 Q~C 2 A~ 10: 46 ~
_ 150~21 ~
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' CLERK CIRCUIT COURT ~
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I FURTHER CERTIFlf that I will aomply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my fo~me~ domic,ile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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' . . .oG : Lewis Hurst (Name)
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Znd December tq66
;.~w~i~,~~'subsuibed betore me this day of ,
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ROGER POITRAS - ~
CIERK CIRCUIT C T Notary Public ~
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gy -~~-c. [l.C. My Commission expires i
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(To bs ~xecvted in duplicate and oriyinal filed with Cle~lc Circuit Court, and duplicat~ vrith Tax Assessor.) ~
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600K 1~~ PAGE 239 e
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