HomeMy WebLinkAbout2904 D~cla~atlo~ ot Domicil~ and Cttize~ship ~
TO THE S?ATE AND COUNTY TAX ASSESSOR,
15i28~
Sl. LUCIE COUNTY, FLORI~A:
This is my decla~ation of Dor~icila and Citize~ship in the State of Florida that 1 am filing this dsy in aooordanos and
in oonformity with Chapter 222, Section 222.17, Flo~ida Statutes. _
I was formerly a legal resident of ___~.__S~~ - - A~~
(City) (State)
and 1 resided at __Rt . 5 BOx 445 B ~Wever 1 have chsnged my domic~le
(Sireet and Number) .
to and am and have been a bona fide resident of the State of florida since 15th day of
Sept. 66 2406 Holidaq Crt.
. 19 and I reside at .
(Street and Number)
FORT PlERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
pnseri here any pertinent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) _
F ILING FOtt1. HOMESTEAD PURPOSES
~r~, ~p At~D RE @~
$'[;~j~tE Cp • - - _
R . .~@~ ~4 ~ .
'S6 r,F~ 29 AN ~ 1: 3 t
_•~~d~
ROG~R PO{7RFS `
~ CLERK CIRCUIT COURT ~
,
i '
~ _
E I RIRTHER CERTIFY that 1 will aomply with all other requirements of a leyal rasident of this State.
{ FURTHER CERTIFY that I have no intention to retum to my former domi 'le, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
V
. . . _
~ c , , : ' ~ ' ~ (Name) ;
' . H. P. BATTLB '
• 1• •
,~e~: , ~G. .
" ~ ~/~C~f@SS~
. . • : ~ ,
~ • U:::~ - 29th December 1966
C~~'yv~~p~and subscribed before me this day of ,
~ .
~ - ~
ROG~
CLERK C OURT Notary Public
~
gy D.C. My ~ommiuion expires
Ro b~ ~x~a+1~d in d~~plicat~ and ori~inal Bi~d with Cl~elc Cinvit Cour~, and duplicst~ wHh Tax Ass~or.)
~'i~~~~' ~ ~0~
~ - - - - _ -
_
. ~ . -