HomeMy WebLinkAbout1798 i~z~~z
Decluatlo~ ot Do~niail~~ and Cftiz~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. llJC1E GOUNTY, FLORIDA:
Thi: i: my d~duation of Oomidle and Citize~ship in th~ State of Florida that I am filin~ this day in aooo~anw and
in aonfarmity with Chapter 222. Section 222.17, Florida Sta~.
I was formsrly a le~al rosidsnt of ~R~~ -j~.-v+,---
~ Kify) (Stat~)
~nd 1 rosid~d at ~ddle Rd. .~bvwvK 1 have charqsd my domidle
(Street and Numbsr)
w and am and have baen a bons fid~ rosidsnt of the State of Florids sinos 3r! ~y ~
November 68 1027 Jam~ica Ave.
, 19 , and I roaide at
(5tres~ and Number)
lORT ~ S~AMT U1CIE COtINTY, RORpA .
and this statbment i: to be taken as my deda~ation of citinsnthip, actual legsl re=idenoe and domkik in the State of Horida.
pnsert hem any pertinent facts, such as sak of propern? or business, or relinquishment of employmsnt
at former domicile, ramoval of fsmily ro new domidle, purchase of horrie, etc.)
FILING FOR HOMF.STBAD PURPOSBS
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~~~ci~ cot~~~.pl~?:
REC~~,/iG`t~~D
'68 NOV 21 11N II: 3
- ~u
- ROGE ~OITRAS
I CLERK CIRCUIT COURT;
i RJRTHER CHtTIFY that i will aomply with all othK nquirarwnts of a Ipal ~ideM of this Stat~. ~
r 1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
- PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
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~ - ' ` :J ~ N M KOBHL~BR
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r t~ - ' ~ , _ AUDRBY F . jGOEHLBR
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i~~ y.S~~'rn`fo~nd w6aaibsd before me this 27th d~ of NOVBMBER 19 6~.
,
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~ ROOER
Cp11RT Notary Public
~y D.C. My Commission expires
Re b~ ~ar1~d iw dvplieN~ and ori~inai fil~d wflb Ci~k CMaiif Cov~. sed d~pliea~a whi~ Tax A~era
d00K1~4 PACE~~~
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