HomeMy WebLinkAbout1650 D~aluation qt Oorr~icil~ and Citis~nship
TO THE STATE ANO COUNTY TAX IISSESSOR, IS~lira70v
ST. lllClE COUNTY. FLORIDA:
This is my decla~ation oE Domicil~ and Citi~ship in th~ St~h of Horida thst I am filirq this day in ~ooorda~a ~nd
in oonformity with Chapt~t 222. S~ction 222.17, Florida Statut~s.
1 was formerly a(pal rosldent of willard Ohio
(City) ~~t~I
end 1 rosidsd at Rt 1~ox 40 . Howwar 1 haw d+s~p~! my domWl~
(StreN and Numbsr) . ~
ro and em and have baen a bona fide rosident of the State of Florida sina ~Y ~
August , 19~..~_, snd I ~esid~ st 310 St.Lucip ~e*
(Strs~t and Numbsr)
FOR~ N~, SAINT tUC1E COUMY. lLORiDA _
and this statsma~t is ro be tak~n as my dsdaration of aNzenship, actval Ipal raidena ~nd domidle in the Sta» of Horida.
pnsen here any pertinent fads, such as ~ale of prop~rry or butineis, or nlinquishm~nt of ~r?ploym~nt
. at former domiclls, romovsl of family to ~ew domiclle, purchass of hort~e, etc.) ,
: ~
Bstablishin~ reiidence
RILEO AND R~COR0~8
37'• LUCIE COUNTY, F~q,
RECORO VE~IFIEO
15~c%586
'6T FEB 8 PM 2 z
CIERK
CIRCUIT COU
RT
~
~
1 FURTHER CEftTIFY that I will aomply with a!I otF~ roquiremsnts of a lepal r~ident of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE,•SA1 lUCIE COUNTY, FLORIDA, permanently.
. i,.~-•.'C~~~~~it::.:-; .
,
'•1ii~it
:3 3 4 ~ - .
~ - ' ~ c~~'n _ ~ Larry llan~"°~Jacobs
, :a % ' _ ' .
_ ' -
• ~ . (p?ddress)
~ -
Sworn to and subsaibed befor~ me tfiis 8th day ~ Feb. 19 6? .
ROGER MITRAi ~
~ ~ Notary Publk
gy D.C. My Gommisian expires
R~ b~ ~uaM~d ~ drplkM~ an~ «i~inal f~d wMl~ Cl~ek ~Circ~k Cw~t, aad duptia~N will~ Taac AwaerJ
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