HomeMy WebLinkAbout2629 Decla~atio~ ot Domlcite an~! Citisenship 16318~ °
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,
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Uom~cile and Citizenship in the State of Flo~ida tha~ I am filing this day in accordanoe and
in conformity with Chapte~ 222, Section 222.17, Florida Stetutes.
. '
I was formerly a legal residenT af _C11L~~IIil~.~1_---~---_--- - nh1° ~
~C;~y~ (State) ~
and 1 ~esided at 6579__Hillside Ave. However I havechangcd my domitile
(Sf~eet and Number)
to and am and have been a bona fide resident of the State of Florida since _1St _ day of
March 67 2712 South 17tb street ~
- - - 19 and I reside at ~
(Street and Number) ~
FORT PIERCE, SAINT IUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence FI~EO ANO RECORDED
ST. LUCIE COUNTY. FLA.
l2E:COFtp V~RIFIED
16318~ -
• '68 JAN 2 pM 2; 33
:.Il JG_%~ :'.Qi i tZ:.$
CLERK CIRCUIT COURT
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHfR CERTIFI( that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCtE COUNTY, FLORIDA, permanently.
;i:':tuu;,;. , ~ -
ti,.~• ~ C :
~v~ ~ C,•,~'%,- `
= (Name)
_ . ~ - _ .T aIDes H. Hingham
l , ' r; : ~ -
- = ~ ~ ' (Address)
- - ~ .
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~ Swoc~ ~b and subscribed before me this 2nd day of .~SIIll~~ . 19-5-8--
ROCsER POITRAS
CIRCUIT COURT Notary Public
gy a-~L D.C. My Commission expires
(To b~ ~x~cut~d in duplicat~ and ori~insl fit~d with it Cou ~ duplicat~ with Tax A~or.) ;
_ Bo~K Pact
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