HomeMy WebLinkAbout0687 D~Cluation ot Domicll~ and Citis~~ship 1`?'3~655
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. UJCiE GOUNTY, FLORIOA:
Thi: ts my decla~ation of Oomicile a~d Citiunshtp i~ th~ Staro of Florida that I~m filin~ this day in aooordano~ ~nd
in aonformity with ChaptK 222, Sation 222.17. Florida Statut~s.
I wa formerly a Is~e1 rosident of Danvera Mass.
(~ity) (Sta»)
and 1~id.d at 7 Hazen Avenye my
(Street and Numbsr)
ro~nd an~ and hsve been s bona fids msident of the Stste of Florida si~oe Sth dsy of
J~lY , 19 68 , a~ I~~e ~ Rt 2 Box 2766 Shannon Drive
(Streef and Number)
l~ORT S~AINT LUGi COUNTY, lLORnA
and thi: ststemsnt is to be taken as ~y~declaration of citizenship, actusl le~ai ~esidenoe and domidle in fhe State of Hortda.
pnssrt h~m any pertinent facts, ~uch as ssle of property or bu:iness, or relinquishment of emplo~ymsm
at ~mer domiale, romoval of family t~ ~ew domidle, purcha~ of home, etc.)
Homestead purposes
FI~ED AND RECORDEO
ST. LUCIE COUNTY. FLA.
REC(1RD VERIFiEt) ~
1'73655
~ '69 JAN 9 AN 9: y
' RO r~ POlTRAS
~ CLER CIRCUIT COURT
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I FURTHER G~tTIFY that I will aompiy with all othsr roquirem~nri of a lepal ro=id~nt of this State.
1 FURTHER CERTIFY thst I have no intention to retum to my former domic3le, ar~d 1 intend to remain in FORT
PiERCE, SAINT UICiE COUNTY, FLORIDA, permanantly.
' ~~~a r~ ~
M°'~"°~ Clarence F. Harris
~
Wtldress)
,~woro:t~. and ~wbar+bsd before me this 9th day ~ _Tanu arp , 19 69.
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~iRK~ pRCtqT ~kT Notsry Public
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8y D.C. My Commission ~xpiros
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