HomeMy WebLinkAbout2877 1'~'i241
O~aluatlo~ Domiait~ and Cltis~nship
TO THE STATE AND QOUNTY TAX ASSESSOR, -
Sl, ltJC1E COUNTY, KORIW~?:
Thls i: my declar~tion of Oomldl~ and Citis~nship in ths State of Horids that I am filin~ this day in aooorda~a ~d _
in oonformlty with ChaptK 2?2, S~ttion 222:17, Florida Statutes.
~ was f«~,.~iy a~i ~sid«,t of Elisabethtown 8orth Csrolina
tCtty) ~St.»)
and 1 rosidsd at $t • 2- BOZ 112 ~r„~~ 1 haw d~a~~p~d my domidl~
(StreM a~d Numbsr) '
to and am and have bser~ a bona fide rosident of the State of fbrida sinoe OCt 11
, 19~, e~ i~~ 407f go. llth 8treet
(Sfra~t and Number)
l~ORT S~AtN? LUaE COIM~ITY, /LORqA
~~d this statemant is to be taken as my deda~ation ot ~itizenship, actual leyel residenos a~d domicile ln fhe Sf~t~ of Horid~.
(Insert here any partinent fads, such as sale of properry or busine:s, or relinqui~ms~t of employmsnt
at fonnK domidle, removal of family to ne~v domiale, purd~sse of home, etc.)
Bathy Jean, Barbara Arin?, ~eldon Andy iii Ye~ee _
_ FtLEO AND RECQ RD_¢D;, .
. ST. LUCi~ COUNTY, FLA.
RECORn ~Ep
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~ '~8 OCT " I 4 PM 2: q ~
ti~
' ROGEi~ POITRAS
CLERK CIRCUIT COURT`
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~ I.FURT~IER GERTIFY that 1 wiii aomply wHh ali othK nquir~rrwnts o# a lepal r~ide~t of th~ Stats.
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I fURTHER CERTIFY thst I have no intention ro mtum to my former domi~ile, and i intend to remain in FORT
PIHKE, SAINT U1CIE ~OUNTY, FLORIDA, permanenHY-
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~ . b~ ~i~ ~ i4th ~ ~ October 19 68
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~oou ~at~?s
a~ac aRa~ coutr ~ Ho~y
ey D.C. IN~r comrrdssio~n ~xptr~s
R~ M«NaNr iw ~*wi ~t~t~.l N.r w1N~ G«!c Crs~i1 CwN. aoi i~Irea1~ wtU~ Tac Ar.~.,?
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