HomeMy WebLinkAbout0470 Fam 8 T. Cd01~ (60i[-~)
Dsclaratioa of Doanicile and Citiseaship
TO THS STATS AND COUNTY TAIC ASSESSOA. ~S1S~~
St . Luci e ~U~~ ~~A:
17~is la my dedaratioa of Domicile and Ctti~sbip in tbe State of Pioricli that I am filiu4g tbis day in aoooz+d-
anoe~ and ia ooafa~mity wlth Sec~ian ~.17, Floslda St~tu~es,
I was fonm~ty a~g~l reaident of Mundelein Illinoi s
and I resicied ~t Rt. 2, Box 134 tstats)
. Ho~wever, I hav~e ~hanged my domidle
(saeet.nd Nuwber)
~o and am and l~sv~e been a bo~na gde reaidant of tba State ~ Fia~ida sinoe First ~y ~
Janu ary 1t~.67 , and I r~s3de st 3 089 Pru i tt Rd .
Port St . I,ucie ~~0°~ 1Od
St . I,ucie
(~b)
and this. sta~a~meat is ~c be taken as my declaration of citizenship; adual legal reside~oe and domic~le in the Stabe -
af F~o~Ida
Ia~at bere my patioent facb, mch as als ofp ~or bu~ne~t, oc relinqnid~meot of empbymmt at
doa~ici~e. remnrd oE fimtiy tio new do~tctie,~~n;6a:e of home. eoc. )
fistablishing residence
h1i11 apply fox homestead
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a ~f1.~0 AND vN?Y~~1.~?•
- S?.REC, RD vER1E1ED
~.5~.sa:~
~61 JAN 12 1?M 9' yg
H~GER pp~TRAS
~~aK ~~RCU?T couRT _ _
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~ I FURT~iER CERTIFY that I will register at my local address when die ~gistratio~ books reopen, and
~ comply with all othar requireme~b o~ a 1e~aa1 rasideut of this State.
~ ` I TrURTfIER CERTIFY that I have no inte~eon to retura b~ m former~,,.,,~,„~~
i ~U~i~tt::J~~1~p~~.,, y uv'++a~avs SII(~ I III~(i ~ I@a1SlII lil
~ ~~~~y Ct~; Port St. Lucie St. I~ucie
, ~ ' • -:,~,~p f
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i'. ~ O!""~"~'~ ~l ~S _ L~%t~(J~ ~
~ ~ 'y1A ~/N
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i = ~n ~ .y t~ L1 : ,r : ~D1ams)
" ~ ~ 3089 Pruitt Rd.
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~ `.,~~p~p0~~pt~scribed before me~is 12th ~y _ (A~tas) -
"~~~riuu~~u~~~~~ .Ianuary
, A. D. la.~LZ~
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f . ~ V P.7~~:~
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~ 1Votary Atblic State Flocida at Large
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; My c~~ ~ - ~s~ i 68'
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~ (To be emeoated in dnplicate aad arigi~l filed wjtL (.'lerk Cirwit Court, aad daplicate wt#h Tu AweMOr)
E i~~e,t~.ccr~,c,~. R _
g~~164 ~ 468
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