HomeMy WebLinkAbout1919 Oeciaration oi Do~nicite a~d Citt:anshi~p
TO THE STATE ANO COUNTY TAX ASSESSOR, ~ 152"~'66
Sl. IUCIE COUNTY, FLORIDA: .
This is my decla~atio~ of Oomicile and Citi=enship in ths State of Florida that 1 am filinq this day in acoordsnos a~d
~n conformity with Chapter 222, Section 222.17, Florjda Statutes.
1 was fo~me~ly a legal resident of New Yo rk Ci t y N y
(c~~?) tst.ro)
and 1 resided at ` 111 WadswOrth . However I have chan~ed my domicile
(Street and Number)
to and am and have been a bo~a fide resident of the State of Florida since 6th dey of
anuarY ,
_ J_ , 19_b.b and 1 mside at ~ 900 So Dixie Highway
(SNeet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this stat~nt is to be taken as my declarotion of citi:enship, actual leyal residence and domicile in the State of Horida.
(Insen here any pe~tinent facts, auch es sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new aomicile, purchass of home, etc.) ,
, Establishin~ residence gT LvC1E ~o~~A
RECORD VER(FfE~~'~~
'6T f .~S~~s ~
E81S~~p;58
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CLERK CrRCUiT CoU
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1 FURtHER GERTIFY that I will oomply with all other requiremenri of a leyal resident of this State.
1 FURTH~R CER~IFY that 1 have no intention to retum to my former domiGle, and I intend to remain i~ FORT
PIERCE, SAINT~~,UC~E-CQUNnr, FLORIDA, permanently. ~
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;~t;t:;:~a:.,;.
:~~L''~'~::.. ~0~~ ~ '
. ~ c:~ (Name)
~~j, Alan H Lish
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Swor~ ~to ~and subscribed before me this 15 t h day of Febr u ar y , 19 . 6?
romus -
CIERK CIRC IT COURT Notary Public
B D.C. My Commission expires
(To b~ ~c~cvtad ie dupticat~ and ori~ina! Rl~d witb Cl~rk Grcuit Court, and duplicah wiTh Tax As~ssor.)
~ ~164 ~1917
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