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HomeMy WebLinkAbout2181 ~ -~•v~v ~ Declaration ot Domicile a~d Citizenship i ! TO THE STATE AND COUNTY TAX ASSESSOR. ' 51. LUCIE COUNTY, FIORIDA: This is my declaration of Oomicile and Citizenship in the State of Florida that I am filirp this day in acoordana and in conformity with Chapter 222, Section 222.17, Florida Statutes. 1 was formerly a legal resident of G~lf t~a*t MiSS ~4iUl~i _ ~~ify~ (State) ~ ~ and I resided at 9 53ru St re~t . However I have chanqed my domicile j ~ (Street and Number) to and am and have been a bona fids resident of the State of Floride since 25th - day of _ January , 19 6b ~ a~ ~ reside at 801 SoLth 12th StrPpt - (Street and Number) ~ FORT PIERCE, SAINT LUCIE COUNTY, FLOWDA ~ and this statement is to be taken as my declarotion of citizenship, sctual legal re:idence and domicile in the State of Horida. . t (Insert here any peninent facts, such as sale of property or business, or ralinquishment of employment ~ at former domicile, removal of family to new domicile, purchase of home, etc.) Homestead purposes . ~~LEO AND RECORDEB'.~ ~ S?.RECOR CVERIf E u. ~67 FE6 22 ~3~ : 01 ` 1529 . ~iOGr~P. ~OITRAS - [ C1.ERK CIRCUt7 COURT i ~ ~ i ~ r € ~ ~ ~ ~ ~ i ~ I RJRTHER ~ERTIFY that I will oomply with all other raquirements of a leyal resident of this State. I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT { PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ > t ~ (Name Carl H. Lau r i ~ ~ ~ ~ (Address) f ~ ;~u:.. ~ - 3 . ~ '~vkojli t6;and subscribed before me this 22 day af February ~q 67 , : , u _ - ~ ~ ~ . . '~i`' ~M,~ ;:.:~K:~~SIRCUIT COURT - Notary Public _ - , "~.~y r~" D.C. My Commission expires (To b~ uncuhd in dupticat~ an~ ori~inal filw~ witl~ Cl~lc Cira~it Courf. and duplicab with Tax Aa~s~or.) aooK 164 ~~~21 r7 ? y ~ y : j - - - - ~ ~,;,=y - qs; ~ :x