HomeMy WebLinkAbout0528 O~cla~ation ot Domlail~ and Citi=~nship
~ - 1'735~1
TO THE STATE AND COUNTY TAX ASSESSOR,
51. tUC1E COUNTY, fIORIDA:
This ii my decla~ation of Domicile and Citiunship in th~ State of Fiorida that 1~m filin~ this day in aooordano~ ~nd
in aonformity with Chapter 222, Settion 222.17, Florida Statutes.
1 was formerly a leyai rosidu+t of South Webster Ohio
(~iy) (Sta»)
end I~id~d at Rt .#t 1 - HovwvK i haw chan~sd my domkile -
(Strest and Numbsr)
ro and am and have been a bons fide rosident of the Sbfs of Horida sinoe 30
February ~ ~q 68 a~ ~ Box 67~Q Rt~2 Howard Rd. Lakewood p$
(Strest ~nd Numbsr)
~ORT !~l~, S~AINT LUCIE COUNTY, RORpA
and this ststement is b be taken as my dedaration of citizenship, actual Is~al r~idenoe and domkite in the Stste of Florida.
pnsert hem any pe~tinent facts, such as aale of property or business, or relinquishment of employmant
at former domicile, removal of family to new domicik, purchsse of horne, etc.) ~
FfL~~ ANO RECOROB~'.
ST. l.UC1E COUNTY. FLA.'
pECORD VERIFI~b
1'73541:
.
'69 JAN 7 AM 9:
F . RO POITRAS
` CLERK CIRCUIT COURTj
I FURT~iER GHtTIFY that 1 will oomply with all othsr roquinm~h of a lepal ~ident of this Stats.
i FURTHER CERTIFY that i have no intention to retum to my former domi~ile, and I intend to ~emain in FORT
PIERCE. SAINT lUC1E COUNTY, FLORI~A, permanently. ~a~~~~~LG/~1 „h
~g~~[~
ROBERT P. NICKBI.L
, :
. • : - ;
= Box 6TI0 Rt#2, Boward Rd.
y- •
_ . . ~akewood Pk.
•
• , • ' z:
~ .,.;;b,~,,,
~
~J c~S~rq~ tp~and wbscribed before ms this ?th day ~ Tanuarp , 19~L4..
-
:1J:3:t:.~~~ '
~ ~
C~CtNT~COURT Notary Pubiic
•
By - ' D.C. My Commission expires
R~ i» ~oaaiNet iw duplkat~ aed ai~isal Al~d wMi~ G~k Ciraiif Cwrt, and d~plicalr wilb Tax At~o~a
„ s ac1~1`5 ~cf 5~'i
-
~~~E~L3.."~'~s~.. ~~~':3P *1."~
.
xa; 41~_ . e..: ~ ° r . o- z.~~i"ysa'~',-a^.I..c~