HomeMy WebLinkAbout1634 D~laratio~ ot Domt~il~ and Citiz~nshtp „~g~~
TO THE STATE AND COUNTY TAX ASSE550R, ~
Sl. llJC1E ~OUNTY, FIORIDA:
This Is my declantion of Oomicil~ and Citi~snship in th~ Stah of Horida ih~t 1 am filinp thit tJay in aooordano~ and
in aonformity with Chapter 222. Settion Z22.17. Florida Statut~s.
~ was formeriy a tpal ~estdent of pbiladelphia penn.
Kih) (Stat~)
and 1~~ded at B ook Hi11 Apt. ~ 6 Rivet~ide ~~w mY
(Sn~t and Numb~~)
ro and am a~d have baen a bona fide resident of the Stsh of Florlds sinoe 1Stb ~y ~
November ~q 6f , a~ ~~J~ n 321 jShad Lane River Park
(Streef and Number)
FORT N~C~, SAINT LUCIE COUNTY. RORIDA .
and thi: staterrbnt is to be tsken as my declaration of dtizen~ip, ectual le~al residenoe end domidle in the Stat~ of Florida•
pniert here any pertinent facts, :uch a: sale of property or bu:iness, or rtlinquishm~nt of employm~nt
st former domicile, removal of-family to new domtcile, pu~ass of honk; elt.)
f
Bstablishing residence 1~I1E0 AN~ R GORp~p :
ST. WCIE CO~MTY, Fi;~.'?
RECORD VERIFIED ~
:t52J`~'s
~ '~t FE8 8 AM 10:59
F~OGER FOITRkS
- CLERK CIRCUIT COURT
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I FURTHER GHtTIFY that 1 will aomply with ell otF~r rsquirennenfs of e(e~al resident of this Sts».
I FURTHER CERTIFY that 1 have no intention to rotum to my former domivle, and 1 i~tend to remain in fORT
PIERCE, SAINT-lt~1~~~NTY. FIORIDA, permanently. ~
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.V, ~ ~ ~',r ~.~~'r~a~~ t (Nsme)
~ `t . ~ K Skivesen
' _ ristian
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- • 'rt' . . }1 = ~r
- ~ s'_'~t.i"':;,~~~ (/~?ddress)
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8tb Pebruarv , 196?
Swotn to and wbsuibed beforo ms this day of .
ROG~ lOITRAt .
~T Notary Public
gy - D.C. My Commiuion ~xpires .
(Te b~ ~oaaM~d M~ipNeaN and ~iaiw~l fil~d wUb~ CMrk Cirari/ Cowf, aAd d~ptiea~l~ wilb Tavc AwNOra
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