HomeMy WebLinkAbout1499 ~i~~
~ D~cla~atio~ ot Domicll~ a~d Citl=~nship
TO THE STATE AND COUNTY TAX A.SSESSOR,
Sl. IUCIE GOUNTY, FLORIDA:
This is my declantiv~n.of Oomicile a~d Gitise~uhip i~ tM Stats of Florida that 1 am filiny this day in ~ordano~ ~n~
in conformity with Chapter 222. Section 222.17, Florida Statut~s.
~ was fonner~y a ~.yei ros~dent of Cleveland Ohio
(CitY) (S1~1+)
~ Baat 49th Street . ~ ,r,y
(Stnet and Number)
b and un and have been a bona fide rosident of the Stste of Florida :inoe ~ B• 1 - day of
68 , a~ ~ 5004 Star Avenue
(Street and Numbsr)
lORT ~IQC~, SAINT LUCIE COUNTY, RORqA
and this staten~ent is ro be taken as my decisratan of atizenship, adual legal residenoe a~d domicile in ths St~te of Florida.
pnse?t here a~y psrtinent fads, such as sale of property or busines:, or relinqui:hment of emplo~yms~t
st former domicile, ranwval of family to new domicile, purchase of home, etc.)
: - Placing children in public schoola
.
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c' z, N -t ~°o
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I RJRTHER CdtTIFY that I will aompiy with a!I otF~er roquir~nts of a Ipal roslde~t of this Stab.
1 fURTHER CERTIFY that 1 have no intention ro return b my former domiCile, snd I intend to remain in FORT
PIERCE. SI11NT L~1~lE~COUNTY, R.ORIDA, perma~ently.
. : . ~ , . L''~ , .CJ~-~,i
_ ~ , ~ , ~ (Nsme) SuaiE Dswson
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Sworn ro and wbsuib~d befor~ me this 10 Septembet ~~q 68,
ROOi~ rO1T~Af -
CL~RK Nohry Publk
~?Ct~c/ M
$ s~? o.c. y ao~«+ .xa~.
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a. r. ...al~ i~ ~Mer. .~i .eyM.~ w.r ,rM~ cMelc ci~i1 c.w~. .rr ,~ri~r T~ac A.......a
~ , ~ 173 F~1490
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