HomeMy WebLinkAbout1222 O~cluatton of Domlail~ a~d Citis~~ship
~ 154283 _
?O THE STATE AND GOUNTY TAX AS.SE350R, ~
Sl. U1CIE COUNTY, FIORIDA:
This i: my declaration of Domicile and Citis~nship in ttw Stat~ oi-F-l~ida that 1_ am filln~ thit day i~ aooorda~ u?d
in aonformity with Chapter 22~, Ssttiw~ 24Z.17, i~ida Statuhs.
I was f«meriy a Ipa1 rosld~+t of Springf ield Il linois
(Cth?) 15t~»~
and 1 resid~d at 2828 Peoria Road , Howw.r 1 h~w chan~d my clankiN
(Stn~t snd Numbe~)
ro and am and have been a bona fide ~ident of the Stah of Fbtida ainos 20th ~y ~
~ctober 66 ~~8 OI.EAND~B ~YS
, 19 , ~nd I roside at
- (Stre~t ~nd Numb~r) ~
fORT tAiNT tYC1E COUNTY. fLORIOA
and this statement is b be taken as my dsdaration of dti~snship, actval Ip~l residena and domidi~ in the Stat~ of Horid~.
(Inss~t hsre any pertinent fscts, ~uch as ale of prop~rty or butin~ss, or rolinquish,msnt of ~mploym~nt
-at former domicile, romoval of family to new domidle, purchas~ of ~ne, etc.)
Establishin{; residence and will applq for homestead _
_
fIL~~ AND RECOR
~i~ .
~T• ECORO vERtF EO
` '6i MAR 2? PM 3:43 .
' 154253
, _
~ ~oc~a ~oilRas
~ ~~ERK CIRCUIT COURT
1 FURTHER CERTIFY that I will aompiy with all othsr requirem~nts of a Ipal re~idsnt of tfii~ State.
FURTHER CERTIFY fhat 1 have no intention to retum to my former domicjle, ar~d ! intend to remain in FORT
PIERCE;t,~iftit~`.1l1CiE ~bLiNTY, FLORIDA, permanently.
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. . Q:,s _ Mamie J. Shelton
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- .Swcrn to and wbsuibsd before ms ~his 27th M2~rCh .
ROOER rO1TRAS -
~ ~ Notary Publk
g ~ O.C. My Commission txpi~
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(Te b~ ~oaarl~d M d~cM~ and e~ieal Cina~if Cowt, aad dup~N wiN~ Ta~ A~~~.I
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