HomeMy WebLinkAbout2895 1~3165
Declaration ot Domicile a~d Citi:~~ship ~
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TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. ll1~lE GOUNTY, FLORIDA:
Thi: i: my decla~ation of Oomicile amd Citizenship in the State of Florida that 1 am filin9 this day in aaordanoe and -
in conformity with Chapter 222, Section 222.17, Ftorida Statutes.
1 was fomnerly a legal resider~t of Oceana Wegt Vir~inia
(City) (Sta»)
Star Rt 1 Box b ,
end I msided at . Howsvsr 1 have cfian~sd my domidle
(Street and Number)
b and am and have been a bons fide ~esident of tha State of Florida since 19th day of
September ~~9~8, and I reside at ~~+5 Ho4bine ttre~t
(5heet and Number)
PORT M~CE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, aciual legal residence and domidle in the State of Florida.
(Insert here any pertinent facts, such as sale of propertX or busineu, or relinquishment of employment `
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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Establishing residence "
C Mr. Gradie D. Mitchem works ? days a weeks and unab~e to get in ~
the ot f ice. ) ;
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FILEO AND RECORO~D' ~
ST. LUCIE COUNTY. FLA.~ ~
R~:COR~ VERIFIED (
~ 1`~3165 '
'68 OEC 2 3 P~1 I: 3 9 '
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~{~~~'OITRAS
CLERK CIRCUIT COURT'
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~ 1_ F~JRTHER C~RTIFY that I will oompiy with a!I other requiremenfs of a Ia~el resident of this State.
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= 1 FURTHER CERTIFY that 1 have no intention to return to my former domiGle, and 1 intend to ~emain in FORT t
PIERGf, SA1NT .6UC{E COUNTY, FLORIDA, permanentty. `
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~ : ~ - X~I~~LCnLl.Ls~ ~f ~G~'~z-..J 4
, . _ ~ - (Name)
_ ' _ ~ Mary Helen Mitchem
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„ , ~ - (Address)
~ . :e;~• `~''Y.:
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S~worn to ~nd subsuibed before me this 23 rd day of Dec embe r ~ ~ 9 6 8
ROGER rO1TRA5
CIRCUIT COURT Notary Public
By Q'"L`''~ D.C. My Commission expires ;
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(To b~ uueuNd in du~lieaN and oei~nal Al~d whh Cl~elc Grwif Cou~f, and duplkal~ whh Tax Asas~or.)
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