HomeMy WebLinkAbout0469 O~claration ot Domi~il~ a~d Citis~nship
' 1'73494
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. LUCIE GOUNTY, FIORIDA:
This is my dscla?atio~ of Domicile and Citi~en~ip in th~ State of Florida that I sm filinq this day i~ aooordanw ~nd
in conformity with Chaptar 2?2, Settion 22~.17, Florida Statuhs.
~ was former~y a ~eqa~ rosideM of ~ulton Alabai~a
(~iy) (Sta»)
and I rosid~d st Route #~4
(Stre~t and Numbsr)
to and am and hsve bsen a bona fide ms'ident of th~ Stat~ of florida sinoe 30th ~y
December ,~q 68 , a~ ~ 304 North iSth 5treet
(Sh~st and Numbe~)
l~ORT ~CE, iAiNT LNC~ COUNTr, RORIDA
and this :tatement is b be taken as my daduation of dtins~ship, actual Iagal residenea and domidle in the State of Fiaridi.
pnsert here any pertinent facts, such as ~le of property or buainess, or mlinquishment of employms~t
at former domidle, ~emoval of family to new domicile, purd~ase of home, etc.)
PIACING C~iILDRBN IN SCHOOL
Sheiby Jesn Calhoun 10 years old
Virgii Wayne Caihoun 13 years oid
FIL~D AND RgGORO~D'
ST. ~lfC1E COUNfiY. Ft.A
RECORD VERIFI~~3~~~
.l.
'69 JAN ~ AM t : t2
~
y~~
~ ROC~R POITRAS
~ . CLERK CIRCUIT COURT:
~ 1 FURTHER CHtTIFY tF~at 1 will aomply with all othsr ~squirar~nh of a le~at restdent of this State.
I FURTHER CERTIFY that I have no intention t~o retum to my former domiUle, and I i~tend to remain in FORT
PIERCE, SAINT LUCIE COUtVTY, FLORIDA, permanently.
~ _(a0,,~`
(Name) Audie Calhoun
304 N, iSth Street, Pt. Pierce, ~rla.
~ (Address) 33450 ~
• _
, .
a"v
t~oirt ~to~~~uburibsd before me this 6th day ~ Janussy 19 dq , :i
- V ~~y .-{.iP;A•-
~ • ~ s•~4~ _ .
c,~ ~ CL~K~: CO~!! Notary Public
y _ :
Y
8~ - D.C. My Commiuion expires .
• ; r -•.~r
±i-- ~~s .r~-~-c '
- st "
: -
Ro b. paail~d iw d~pNca~..ea o~i~in.~ fil.a wiel~ u«k eie~if eAwt, .ud dupiial. wiN~ T.oc A~...o~a
~ ~ .
~ s
~
„ _ . ~~~~'~-~r
= ' _