HomeMy WebLinkAbout2804 t633#~
Declarati~n ot Domiciie and Citizeflshlp
TO iHE STATE APlD CUUNTY TAX ASSESSOft.
;i lUC!E COUNIY, F?ORIaA ~
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ih~s ~s %+~y .icc~a~at+on oi Jo:»~ute a:~d C~t,zensh~p in the Sta~e of Flor:da that I am filirg tiiis day ~n accordance and
tonfom?ity •N+th Chapter ?2?, Sect~on 222.17, F1o~ida Statutes. ~
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1 wat to~n~eriy a~e._.~i r~siclent of Bath Penasylvaaii
(Cily) (Sta!e)
+•~d f res:ded at R D 1 ~-+o~vever 1 have changed my domiGiie
(Street and N~n~ber)
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and or.i and have be~r: a tk~r~a fide resident of the• State of Florn-~a since-------~ 31d day ot
September . ~y 67 ,~~a ~~es;de a, 2I02 Blizabeth ave__
( (Street and Number)
FORT PIERCE, SAINT WCIE COUNTY, FIORIDA
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ar.d r~:s stater~:er:t ,s ~t~ be s.~ken :es ~Tiy de~clar~t;on of citiz~nzhi~, act~:at ~eyal res~c+en<e and ,i:;^;~cfie m the S!ate ct ~:~rida ~
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{I,rert hnre ~„y pe:r:nent fac!s, svch as safe of pzoperty or bus~ness, or rei~nqu~shrnent of empfoymen! .
~i former do^~ii~ie, .'e~~r~va~ of fa~~~~ly to new domitile. ~~rthase of home, etc.)
establish residence
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FILED AND RECOROED :
ST. LUCIE COUNTY. FLA. ~
RECORO VERIFIED
~ 1633f1~
'68 JAN ~ :18
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~o~~-~ ~o~T~,~s ;
~ CLERK CIRCUIT COURT ~
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I FURTHER CERTIFY that I will comply with al! other requirements of a legal resid~nt of this State. ;
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I FvRTHER CER7IFY that I have no intez~ion to return to my forr~t:r domi~=fe, and I irtend to remai~~ :r~ i-OR+ !
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FIERCE, SAINT LUGIE COUNTY. FIORIDfa, aermanensly ;
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, ' . - . - (Name1 ~
_ ~ ` ~ ~ Raymond Kane ~
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- :s . ' ~ , ' , ~Z , - tAti;irescl ~
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C~~.~~,nlcan•t~iOa+~~,subscrsb~d !;efore me th,s _ 8t~cfay of Januarq » 68 ~
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ROGER P017RAS - ~
RK CIRCUIT COURT No'ary P:~b::c
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gy - - - - - - D.C ,V: f Co:r.m=ss~on e~a;~es _ _ :
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(To be executed in duplicale and originsl filed with Clerk Circuit Gourf, and duplicate with Tax Assessor.) •
~169 z~~s
No .