HomeMy WebLinkAbout2735 Declaratlo~ of Domictle and Cittsenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA: 16S1S3
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 22?, Section 222.17, Florida Statutes.
I was formerly a lega) resident of ~esburg _ Indiana
~C~ry~ ;
~tate)
and I resided at Rt 2 BOx 176 However 1 have changed my domiCile
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since 28th- day of
______Nos~. t9~Z, and I reside at Causeway Trailor Court
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any pertinent facts, such as sale of property or busi~ess, or relinquishment of employment
at fo~mer domicile, removal of family to new domicile, purchase of home, etc.)
.
Establishing residence
ST~ lU~ ~E ~ RECOROEp
~
^nn, ~ 7UlJTY, F(.A.
r~
. iss~83
68 ~ y ~y 10 :
21
~~r~:-:-
' ~~ERK ~~R~~~T COURT
f
I
tE
I
~
!
~
~
E
~
a I FURTHER CERTIFY that 1 will comply with all other requirementa of a(egal resident of this State.
~
~ 1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
;,;;~:~r :r;. .
~ ~ ~ ' '
~ ; . ~ C N~
~ , ~''r : ,
c : ~t ~ /i ~~i~ =
~ - ~:.f-.~ (Name)
~ y . - ~ - Ralph W. Brugh
~ : ' ` - •
_ • ti ` ~ ,
? - ' • ~Wfi~Jf wif e
~ ~•-;~r Kathrpn L. Brugh
~ ' _ -
Sworn to and subscribed before me this 14th day of March ~ 19 68
~
~
~
~
~ ROGER POITRAS
~ -
CIRCUIT COURT Notary Public
L
~
By D.C. My Commission expires
~
~
~
~ (To ~~xecvt~d in duplicaM and original filed wiih Cl~rlc Grwit Court, and duplicah with Tax Ass~ssor.)
~ 800K ~ ~O PAGt ~ ( ~
~
. ~ - _
; . - ~
~ ~ - ~ - ~ ~ ~ ~ & ~
_ ~ _ ~