HomeMy WebLinkAbout1473 o~ciaration ot Domiciie and Citiz~nship I-~~~'~'3
TO THE STATE AND COUNTY TAX ASSESSOR,
ST, IUCIE COUNTY, FLORIDA:
This is my declaratian of ~omicile end Citisenship in the State of Horids that I am filin~ this dsy in acaordanos and
in ao~formlfy with Chspter 222, Section 222.17, Floride Statutes.
1 wa: formerly a legal rosident of Shrewabury Maes.
(City) (Stat~)
and 1 resided st 6 He9the7~'wOOd Drive ~~ve charped my domkile
(Street and Number)
to ~nd am and have been a bona fide resident of the Stats of Florida sinoe OctOber 26 day of
, 19~t$, and I roside at 3009 l[ornin~sfde _Rlvd.
(Stroet and Number)
I~ORT NERCE. SAINT LUCIE COt1NTY, I~LORIDA
and this stat~ment is to be taken as my dadaration of citizenship, actual laga) residence and domicile in the State of Horida.
pnse~t hero arry pertinent facts, such as sale of properry or business, or ralinquishment of employment
at ~mer domicile, ramoval of family to new domiale, purchase of home, etc.)
Declaration of citisenship
. ;
FII.ED AND R~C_QRDED
ST. LUCIE -COUNTY. FLA.
HE C~O,Q~~i ED
ir
'68 ~NOY 20 AM 11:~00
a,.~J
R03E POITRAS
~ CLERK CIRCUIT COURT
,
F
I FURTHER GHtTIFY that i will comply wtth all other roquiremsnts of a le~al rosident of this State.
1 FURTHER CERTlFY that I have no intention to return to my former domicjle, and 1 intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
::`~s ~ . ~ •
. ' ~..•i,- z
,•~i);.`-,•~~C~~L n~ld L. Price 1
- • 3 . ! j ' o~ta ' i S
~ t~s~l' - - ; ' i / ~
- ' ~ . ~ ~O [ = i t
~ ` ~
':~1• - ~ `r ~d~lSS~ t
~ ~e ~
~ l~ ~ • . . ' ~ • ` ~
S~ip
t~%.nd :ubscribsd before me rhis 20th day of Aovesber , 19 68 . ;
i
< ~ ` {
I
C
~ ~
~ ~ NO~~f~/ PU~IC
~
" u.c. Mr co~,~,i~o~+ .x~~
" ~
R~ M~cw~~ M d~icM~ a~i ~i~Mai f~ wi* CIM# ~kwiN Cw~~. .aa T.~ ~...«.~a
~~1?4 ~f1469
~s . - . .