HomeMy WebLinkAbout1146 DeClaratlon ot Domi~ile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 164113
Sl. LUCIE COUNTY, FLORIUA:
This is my decla~ation of Oomicite and Citizenship in the State of Florida that 1 am filing this day in accorda~ce and
~n conformiry with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _~~el____- _ 1~1851681pp1 _
~C~y~ (State)
xt 3 B~Z ` . However I have chan ed m domicjle
and I resided at 9 Y
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since .~.tZi__ day of
__-~@~ugty-_--_._-_--, 19.~!$ , and I reside at SOUth 25~h 8tr@@t
(STreet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in ihe State of Florida.
(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, purchase of home, etc.)
~
l3ntering Claiborne I,ee Hammons in the 7th g rade
F11.E0 AN~ RECOROED
FLA.
ST.P
V~~( f?n ~FRI IEU
164113 ~
~ ~sa FEB s a~ 9: ys ~
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~ ~~un~cs
; CLERK CIRCUI7 COURT
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,
k' I FURTHER CHtTIFY that 1 will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retum to my former domiGle, and I intend to remain in FORT
~
~ ?IERCE, SAINr:Lt7~'1£:.~OUNTY, FLORIDA, permanently.
~ _~i ~Cp ~i. _
, , ''t ~•n ~ ~ ~ ~.4-~~l~ LJ ~ ~~/V~ .i
~ J _ . _ ~ ~ - ~ (Name)
~ _ " ' - _ Ella V. Hammons ( ldrs. ~laiborne )
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~ ~ .,~v ~'~v , > ~ (Address)
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~i Sworn to and subscribed before me this 6th day of February 19 68
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r"<;
ROGER POfTRAS
K CIRCUIT OURT Notary Public
g °`t--~~ D.C. My Commission expires
Y
(To bs sxe=uted in dupliute and original filsd with Cle?ic Circuit Court, and duplicate with Tax Assessor.)
a~K~70 ~f114~,
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