HomeMy WebLinkAbout1868 Declaratio~ ot Domicile and Citisenship 164613
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. lUC1E COUNTY, FLORIDA: i
This is m declaration of Domicils and Citizenshi in the State of Florida that 1 am filing this day in accordance a~d ~
Y P ~
~n conformity with Chapter 222, Section 222.17, Ftorida Statutes. ~
I was fo~merly a legal resident of ____~1tA~i.~~$~9~___--_- ~Iew Yerk _ ~
(City) (State) ~
and 1 resided at 9__ _ p3rie StrBe t~08d _ ~~,,,ever I have changed my domiCilc ,
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since -__1at day of
_September 19 67 , and I reside at _ 3609 SO Indian xiv ~r Drive
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment ;
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
Establishing residence ~ `
.t6~613
FILED AND RECORDED j
ST. LUCiE C~UISTY, FLA. ,
,..'~,_.t~)
_ _
i
'Sg Ft~ 21 i~~~ 9: 18
; ..r~ . •
~ ~ ; ' =~~r: CIf~CUiT COURT
I
I FURTHER CERTIFY that 1 will comply with all other ~equirements of a lega) resident of this State. -
i
i
1~ j
t fURTHER..CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
,,,;I:il:ldli: - i
PIERC~;~&A~MT ~~S~JCQU.NTY, FLORIDA, permanently_ ~
. /;i;~~i.' ~
:f ~ . • . " ~ 4 ~ t ~
~ -
- . c ~ ~ - (Name) ~
~ ~f = ~ • Bror A. Petter~enn .
_ - ~
~ ~ • , -
~ ~ fi G ~ ' ~ (Address) i
. ~
21at Feb. 68
Sworn to and subscribed before me this day of , 19 .
OQER POITRAS
~ LERK CIRCUI OURT - Notary Public
~ gy °t'~~ D.C. My Commission expires ~
€
t
(To bs executed in duplicats and oripinal filed with Gerlc Grcuit Court, and dupliut~ with Tax Assessor.) `
~ g0ox1 iU PAGE~~~
-
~~r~~~w~~ ~ ~
w.~ _
~