HomeMy WebLinkAbout0688 ~
_ ~ ~cia~ation ot . Domicll• ahd Citiz~nship 15195~
TO THE STATE AND COUNTY TAX ASSESSOR, .
51. IUCIE COUNTY, ~IORIDA:
This is my declarotio~ of Oomicile and Citisenship In ths Stats of Norid~ that I am filin~ fhis day in aooordana~ and
in oonformity with Cfsapter 2ZZ. Settion ~2~.17, FiorWe Statutes. -
1 was formerly a Ipal roside~?t of ~r~n - OhiO
Kity) (Sta»)
and 1 resided at 571T Manchester Road ~
(Str~et and Number) ,
to and am and have baen a bona fids r~ident of the State of Florids sinoe 15t - day of
December " ,~q 66 , a~ M~o~ pl ar+tn CoLrt
(5treet s~d Number)
FORT MERC~, SAINT LUCI! CONNTY, RORIDA
and this :tatement is to be taken as my declaration of citizenship, actual~ega) refidena and domidls in the State of Florida.
pnsert here any pertinent fact:, :uch- as sale of property or bu:insu, or relinquishment of employmMt
at former domicile, romoval of family to new domicile, purchsse of home, etc.) ~
1 Bstabiishing residence and will appiy for homestead ' .
flLEO ANO R COfl D~.
8T. l.UC1 RO V~RIF~I~D
RECO ,
151959
'6T JAN I T AM 1 I: 00 -
i _ cz~
i ~
F ROGER POItRA$
CLERK CIRCUIT COtjR!' _
I FURTHER GERTIFY that 1 will aomply with all other roquirs~r~fs of a lepal resident of tfiis State.
. ~
_ ~
. ~
I FURTHER CERTIFY thst I have ra intention to rotum to my forme~ domic3le, and I intend to remain in FORT f'
PIERCE, SAINT lUCIE COUNTIf, FLORIDA, permanentiy. . k
l`
.~j'-•~l=i ' i
'~,t1~~1«~~t~ii::ll~""... f
\~~+`1•~<~: ~ ~
. ~~~~1~ ~`,i~i /i
, ~ i~~. ~f ' . • ~
r'k~4 CG/'.'~;~= - James W. Harpold ~
~ 3y'.
-~i~: ~R~; _ ` Q ' ~ _
4•f~^ = Y ~
_ ~~n 'ry ~ btarabaes)
~ ' -~~~;~~c _ ~ir ~nia U. Harpold
,
i, '•~y••~.~,
.~1~ J Y , ~96~
,~~'$W~ttfto~and wbsaibed before me thi: 17th d~ ~ anaur .
_ . -
ROGER rO1TRAS • -
qRCtlIT ptKT Notary Pubik
~ ` -
By D.C. My Commission expires
Re b. .x.a»a M a~pik.~. .n~ o~l ril~.a ,w~ a.h ci~ co~, .~a aupu~a. T.x A.....o~a
~ 600K164 ~ 6~5 ~ -
- ~ ~ _ -
.