HomeMy WebLinkAbout0862 Declaration o~ Oomicile and Citlse~ship a
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TO THE STATE AND COUNTY TAX ASSESSOR,
S1. lUCIE COUNTY, FLORIDA: ~
This is my dettaretion of Oomicile and Citizenship in fhs Stats of Florida that I am filinq thi: day in acoordanos and
in conformity with Chapter 22Z, Section 222,17, Florida Statutes.
I wes formerly e legal resident of - S~?~ert Islagd. N Y H w Yo~c
(Ciy) (Steh) •
and 1 resided at 35 s~~r . Howevsf 1 have cha~gsd my damidle
(St~eet and Number)
ro and am and have been a bo~a fide resident of the Stats of Florids since ~th day of
DeCember ~ ~9 and I reside at - 76A ~yp:'e88 Str'eet Rivel~ Park
(Street and Numbsr)
FORT PIptCE, S/~INT lUC1E COUNTY, RORIDA
and this atatement i: ta be taken as my declaration of citizenship, actual legal reside+xs and domicile in the State of Horida. ~
(Insart here any pertinent facts, such as ~le of propeny or buainess, or ~elinquiahment of employment ;
. ~
at former domicile, remova! of family to r~ew domicite, purchass of home, etc.)
Establiahing residence
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S?'RECOR~ VERI~IED _ •
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'6i JAti 23 AM 10
~o~TaAS ~
RO~ER
6t
ERK ~lNCU1? C01l~
1 RIRTHER CERTIFY that 1 will comply with aU other requiremenis of a le~sl resident of this Stste.
~ I FURTHER CERTIFY that I have no intention to retum to my former domiUle, and t intend to remain in FOR7
,~~tis ic; trr::::
PIERCE, SA~Pf't;~C1E~y1.T1f; FLORIDA, permanently.
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V , . r X ~
:~',.~'w~~- ,_,~~,ri~~ - Mame~
' _ - ' ~ ~ - A. R. Huber ~
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..-c~ (Address)
Sworn to and subscribed before me this ~3~. day of dsnaury ~ 19 67
;
~
RC4FR POITRAS
CIRCUIT CAURT . Notary Public .
~ D.C. My Commiasion expires
(To b~ unc~f~d in duplicab ane! ori~inal Hl~d with Cl~ek Cirwit Cou~, and dupticah wiTh Tax A~or.)
5~~64 ~ 859
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