HomeMy WebLinkAbout2642 _ D~cla~atlon ot Domlallf ar~d Citlz~nship
TO THE STATE ANO COUNTY TAX ASSESSOR, ~~,,~A~~
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Sl. UJCiE GOUNTY, F10RlDA;
Thi: is my dacta~atian of Domicil~ and Citiz~~hip in th~ Stat~ of Ftorida that i am fllin~ thfs day in aooordana ~nd
in oonformity with Chapt~t 222. Settion 222.17, Fl~ida Statut~s.
1 was fornerly a Ipal res~dsnr of ~arleston W Virginia
fC~tY) ~Std~)
112 Sheridan Circle
end I rosided a~ . Fbvvsv~r 1 Mw chs~q~d my domi4il~
, (Snwt and Numbsr) -
ro and am and have been a bona fids resid~nt of fhs Staf~ of fiorid~ sino~ 18tb day oi
~ April , 19 6? a~ ~ 1512 Citrus Ave,
(Streft and Numb~?) ~
FORT MlRCE, SAINT LUCI! COUNTY, RORIDA
and this statement is to be taken as my declaration of citiu~ship, actuel Ispai ~esidenos snd domidl~ in the Sta» of Horida.
(Inse~t here any partinent facts, :uch as sale of prop~ry or busl~ess, or rellr~qui:hm~nt of emplo~yrtNnf
st former domiciie, romovsl of famity to nsw domicit~, purchas~ of Fiorr~, Mc.)
~ntering Raymond Scott Ostendorf in the Sth grade ~
" B ambi Lynn ~ in the 2nd grade
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R~COR VERtRI~ ~
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~ERK C
RCUI TR~$ -
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I FURTHER C'HtTIFY fl~t 1 wtll oompiy with ell o~ nqui~ of a tpal rosident of fhis St~t~.
t FURTHER CERTIFY that 1 have no intention to retum to domiGle, and I intend to r i~ in FORT
PIERCE, SAINT 1UCIE COUMY, FLORI~A, permsnently.
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:gil~+.l; (Name)
: _;;r ~ mond C. Ostendorf
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,~~~"t.:: ` 19th A ril - .
:,'~,+r:,,,?~°",Ytt?•ta and subsuibsd before ms ihis day ttf p , 19 67 ,
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ROOE~ ?01TRAS .
. ~ Notary Publk
A.t.~i..t.t~i ~.r ~t-~c.G~
BY G.C. My Commissbn ~xpiros
!1'e b~ ~oc~aM~i iw drpiicaN and oei~Mal fN~d vrMb Clrek Cka~it Cow~, aed d~pikM~ wi~h Tax Aw~a
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