HomeMy WebLinkAbout2478 DeClaration~ ot Qorn~cile and Cit~zenship ~
1Si0~~1
TO THE STATE AND COUNTY TAX ASSESSOR.
51. lUC1E COUNTY, FLORInA: ~
This is my declaration of Domitile and Citizenship in the State of Florida that 1 am filing this day i~ aoeordanoe and
~n oonformily with Chapter 222, Sectian 222.17, Flarida Statvtas.
1 was for;nerly a legal resident of A~~p OhiO
(City) (Stats) ~
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and I resided at _ 1474 Oakwood Ave • Howevei I have changed my domic3le
(Street and -Numbe~)
to and am and have been a bona fide resident of the State of Florida since 21~t _ dey of
_ D~cembcr , ~q 65~ and I reside at Rt 1 Box 153 Beau Rivage,Stuart
(Sireet and Number)
FORT PIERCE, SAINT LUGIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, actua) legal residence and domicile in the State of Ho~ida.
(Insert here any pertinent fads, such as sele of property o? business, or relinquishment of employmeot
at former domicite, removal of family to new domicile, purchase of home, etc.)
fistablishi~pg residence
F~~~Q AND RECOAO p-
ST. LUCIE COUNTY. .
RECQ~144FIE0
1 1
'66 DEC 21 AM 10:2q
CLERK CIR U ~ COURT
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~ I FURTHER CERTIFY that 1 will comply with al) other requirements of a legal resident of this State.
I FURTHER CERTIFY ~hat I have no intention to return to my fo~rner dom~cjle, and I intend to remain in FORT _
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PIERCF„ ~~QT. L~,)CIE COUNTY, FLORIDA, permaneMly.
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~'`'`~~~~~~y ~~'Gi'~~ -J~~~
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_ ~ ',rz•,-'~ R?; (Name)
- - :•qz' Lucian F Michaei
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Sworn to and subscribed before me this 21 day of December , 1966
ROGER POlTiFAS
GLC%,tGG UR C UR~~G(~ J Notary Public
gy ~ ~ D.C. My Commission expires
(To b~ ~x~cut~d in duplicat~ and ori~insl fit~d witb Cbrlc Grcuit Court, and duplicst~ with Tsx Ass~uor.)
~ a aK 162 .75 -
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