HomeMy WebLinkAbout2697 Declauatio~ ot Qo~nicile And Citistnship js~i~8 ~
TO THE STATE AND COUNTY TAX ASSESSOR, :
51. lUC1E COUNTY, FlORIOA:
This is my declaration of Domicile a~d Gitixenship in ths SWto of Flo?ida that 1 am filing this day in attordanos and
in conformity with Chapte? 222. Section 224.17. Flotida Statutes.
I was forme~ly a{egal ~eside~t of N.Y.C. . N. Y.
(City) (Stab)
and 1 resided at 640 BASt 236th St. ~,,,~,~var 1 have charqed my domidle
(Strest and Numbe~)
to and am and have been a bo~a fide ~esident of the State of Florida sinoe 26th day of
Deceober 66 602 B1 Rancho Dr.
, 19 , and ! ~es'~de at
(Street and Number)
fORT MERCE, SAtNT LUCiE COUNTY, RORIDA
and this statement is to be taken as my decla~atw~ qf citizenship, actual legal residence and domicile in ihe State of Hotida.
(Insert here any pertinent facts, such as sale of property or business, or reiinquishmant of empioyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILING FOR HQMESTBAD PURPC~SBS
R1LE0 AND R ~p p ~
ST. LUCI~ CO~NT-Y. ~ ;A. ~ _
, RfCORO VERIFiEO
15ii68 ~
'68 DEC 27 Iu1 I I: 3
RO~ER PpITRAS
- c~aK ;,;RCUir cou~r .
; I FURTHER CERTIFY that 1 will oomply witl~ all other requirements of a(egal resident of this State.
. _ ~
~ - 1 FURTHER CERTIFY that I have no intention fo retum to my former domicjle, and 1 er,tend to remain in FORT ~
~
k PtERCE, SAtNT LUCtE COUNTY, FLORIDA, ~ermanently. . ~
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L c';'i~~y'.,~ , (Name)
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ROBERT SPROLL
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~~'~C~~w~' ~~a~nd subsaibed before me this 2Tth day of December 19 66
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UIT C Notary Public ~
.
BY D.C. My Gommiuion expires
(To b~ ~ac~evl~d in duplieah and o~inal Al~d witl~ Cl~rlc Cira~if Cou~t, and duplkaf~ wiM~ Tax A~s~o~.)
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