HomeMy WebLinkAbout0875 ~
D~cla~ation ot Domicil~ and Cit~~nshlp 1~~2
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. LUCIE COUNTY, FIORiDA:
This is my datlaratio~ of ~omitile and Citizenship in ths State of Florida thst I am filin~ this day in sooordano~ ar?d
in con(ormity with Chapter 222, Section 222.17, Floride Statutes.
I wa: formerly a legal rosident of ~RTHIN6TON OHIO
(City) (Stab)
snd 1 rosidsd at 121 WBST 30TJr1~I NGTON AVBNUS . Hcwevaf 1 have cha~qsd my domidle
(Street and ~Number)
ro and sm and have been a bons fide ~esident of the State of Florida sinoe lst day of
NOVBMBBR , ~ q 6 8, and I reside at 302 OLIVB AVBNUB ~ PT .P IERC~ ~
(Street and Number) pj~I~
fORT M~E, SAINT LUGE COtlNTY, FLORIOA
and this statament is to be taken as my daclaratio~ of citizenship, actual legal residenoe and domicile in the State of Florida.
pnsert here any pertinent facts, such as sale of property or buainess, or relinquishment of employment s
at former domicile, removal of family to new domicile, purchase of horr~e, M~c.)
HOM&STEAD PURBOSES
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1 RJRTHER CHtTIFY that 1 will aomply with all other roquiromenK of a lepal reskknt of thi: State.
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1 FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~
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WALTBR B. FULTON (Name)
x ' ~ _ , 302 OLIVB AVEI~UB,PT_PIERCE,FIA_
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`'S'wan~~~and ~suascr~bsd b~for~ me th~s 13th ~y ~ J/r1 UARY , 19 69 . i
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By D.C. My Gommission txpins
R~ M~aaaN~ M~IicN~ ~wd ~i~i~al fiMa will~ CM~k CMaN Cwr~, awd ~ wilh T~c A~~.1
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~i,75 ~ ~ ~
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