HomeMy WebLinkAbout2632 Oeclaration ot Domicite a~d Citizenship 1~32~2
TO THE STATE AN~ COUNTY TAX ASSESSOR, ~
51. lUC1E COUNTY, FLURI~A: i
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This is my declaration of Domicile and Citizenship i~ the State of Florida that I am filing this day in actordante a~d i
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~n confo~mity wifh Chapte~ 2~2~~ect+on 222.17, Flo~ida Statules. ;
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I was formerly a legal ~es~de~,t of ._N~w. YQrk ~'it~--- N Y ~
(City) (Stare) ;
224 B 81 St ilCt However 1 have chan m domitile
and I resided at - - - ~ y .
. (St~eet and Number) ~
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to and am and have been a bona fide resident of the State of Florida since 18Lh day of 's
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July 19 _67and 1 reside at _605__Azalea Ave. ~
~ (Sireet and Number) ^
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, act~al legal reside~ce and domicile in the State of Horida. ~
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(Insert he~e any pertinent facts, such as sale of property or business, or ~elinquishmwnt of employment .
at former domicile, removal of family to new domicile, purchase of home, ett.) ~ ~
Establishing residence ~
F~LEO aND RECORDED
ST. ~V~~E COUNTY, F~A,
RFCOR(? y~'F~~
: ~s`~ r 2 .
68 JaM 2 PM 2; 33 '
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CLERK CIRCUIT COURT
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I RIRTHER CERTIFY that I will oomply with all other requirements of a legal resident of this State. ;
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I FURTHER CERTIFY that I have no intention to return to my former domiG~e, and I intend to remain in FORT
PIERCE, SAII~T :L1~1.~~,JE_ COUNTY, FLORIDA, permanently_
~ ~ £ ` ~ x C~LG,~,~ ~'Z~!-c~.~
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- - ' ' - Albert l~a~~e~
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- ~ - . (Address)
Swo~n to and subscribed before me this 2~1d day of .~an . 19~28--•
ROGER POITRAS
K CIRCUIT C URT Notary Public '
gy ~.C. My Commission expires
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(To b~ ~xecvt~d in dupliuh and ori~inal filed whh Cl~rk Grcuit Cour?, and duplicsh with Tax Ass~ssor.) ~
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6~OK1V9 PAG[~6~3 i
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