HomeMy WebLinkAbout0922 . . 1sso~~
D~cl~ratbn ot Dom1a11~ and Citis~nshtp `
TO THE STATE MID GOUNTY TAX ASS~SSOR, ~
ST. Lt1C1E COUNTY. KORI~A:
Thi: is my decla~ation of Domials and Citi~nifiip in tFw Stat~ of Florida th~t i am fllirp this day in aooordana and
in oonformity with Chepter 2Y2. Settion 422.17, Florida Statut~s.
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1 was fornns~ly a le~al resld~nt of He~dCrso ville - North Care1_~na
- - (CItY) . (Stst~) -
and 1 rosided at Flat Rock,ROUte 1 . However I hawchsn~d my domidN r
(Sn~et and Numb~~)
ro and am and hsve been a bona fids restde~t of th~ Stab of Florida sinos ll~th day o#
1~IaX. , 19~_, snd 1 re:ids at ~ P
(Straet ~nd Nwnber
PORT MERC~, SAIMT LtlC~ COUNTY, R,ORIdA l
and thi: statement is to be taken a: my declaration of dti~nship, ~ctusl le~al r~idena and domidle in the State of Horida.
qnsert h~re any pertinent facts, :uch es sale of propsrry or buainsu, or reltnquishmsnt of employm~nt
at former domicile, reRnoval of fsmily to new domidle, purchase of home, ~tc.)
Bntering Denise McMurray in 4th Grade
I.UCI~ COU TY. ~ .
RECORO YEtRiF1ED
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'i '61 MAY i 2 IW 8: 43 ~
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RocEa rolTiti?s
6l.ERK EtRCWT C@tiH~
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1 RJRTHER CHt71FY that i will aomply with all ofher roquiremenn of a le~al residsM of tht: State.
1 RIRTHER CERTIFY that I have no intention to retum to my former domiCile, end I intend to remain in FORT
PIHtCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy.
(Name) -
_ = Tho~as J. Blackweli
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.1'ai'~.'~' •Q-
~ sy t~ ~ s~r4icri~~ed before me this ~~L- day of M~ . 19~7.
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COURT Notiry Publk
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gy D.C. 11Ay ~ission expi~
(Te b~ ~ocsa~i ~ d~pN~a1~ aed e~i~inal fiNd wMM CINIc CircYM Caiey and d~pii~M~ wiN~ Taoc A~or,?
~ i66 ~ 9~0. ~
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