HomeMy WebLinkAbout2839 oeclaratlo~ ot Domicile and Cltizenship 1s~43
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, fIORIDA:
This is my declaration of Domicile and CitiZenship in the State of Florida thst 1 am fiiing this dsy in acoordanoe and
in conformity with Chap~er 222. Section 242.1?. Florida Statutes.
1 was formerly a legal resident of Ft. Ca~pbel~ Ky.
~C;~y~ (Sta»)
POSt ~ Quaittr3 However 1 have cha m domic~le
and 1 resided at - Y
(Street and Number)
to and am and hsve been a bona fide resident of the State of floride since ?th dsy of
~ August 6? 102? Nlispana Ave.
_ , 19 and 1 ~eside at ~
(Shaet and Number) ~
~RT r1EltCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declsrotian of citizenship, actusl legel residence and domicils in the State of Norlda. (
{
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
~
at former domicile, removal of family to new domicile, pu~chase of home, etc.) '
~
FILING POR HOMESTBAD PURPOSBS
FI~ED AE1D ~tECOROED
ST. LllCIE CQUP:TY. FLA.
~~_COi ~ ~ r:IFlr_D
163343
'E8 8 PM : 5 6
, . ~ - ~t~~~
_ • .=;1~ .
CIERK C~R~UIT COURT
1 RJRTHER CERTIFY that 1 will comply with all other requirements of a leyal resident.cf this State.
.
- 1 fURTHER CERTIFY that I have no intention to retum to my former domitile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~
(Name) \
, CHP.STBR B. LIBBY ~
: ~ • - .
~ ~ - (Address)
• y v - .
, Sw°n!~ta and-~acribcd before me this 8th day of JANUARY l , 1968 .
~
- - .
ROGiR' -
~ ~pV~ Notary Public
.
gy D.C. My Commission expires t
~
(To b~ ~x in dvplicat~ and ori~inal Rl~d with Cl~ric Gra~it Covr~, and duplicaN wilh Tax As~swr.)
Qo~C169. r,~~820