HomeMy WebLinkAbout1280 Deciaration of ~on~i~il~ and Citl:enship
TO THE STATE AND COUNTY TAX ASSESSOR,
s~. wciE ~ouNnr, F~oai~a: .L'74Q80
This is my declaration of Domicils and Ctizenship in ths State of Norida that 1 am filin~ this day in aooord~~ and
in oo~fo~miy with Chapte~ 222, Section 2~2.17, Florida Statutes.
I was formerly a legal resident of Staten Islaad New York New York
(city) (Staro)
and 1 rosidad at 460 Brie lle Ave. ~~ve chan~sd my domidle
(Stteet and Number)
b and am and have been a bona fide resident of the State of fiorida sinoe day of
August , , a~ ~ 3U~ ~andia Drive port St _Lucie _
(Street and Number)
I~ORT M~CE, SAINT IUCtE COUNTY, RORIDA _
and this statement i: ro be tsken as my declaratwn of citizenship, actual legal residenoe and domicile in the State of Horida.
pnsert here any pertinent facts, such aa sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domiale, purchase of home, etc.)
Establ ishing residence F~~EO AND RECOROE~~' ~
ST. LUCtE CQUN~~ ~LA.
- RECORD VERtF1ED
-t7'4C~g0
. '69 JAN 22 pM 0 ~
y-~
RO E~T -
CLERK CIRCUIT COURT
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1 RIRTHER ~ERTIFY that I will aomply with ali other rsquire~r~snri of a lepsl resident of thls State.
~ 1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 iMend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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. G (Name)
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~ ~ ~J~;,~ ; Olive A. Ricketts
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' 22nd January 69 `
~ ;,.,~"~q~~iid wbscribed bsfore me thi: day of 19 .
""f"':9+.1' '
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~eo~e ra~~?s
~ t.l~t'tNT OtJRT Notary Public
Sy ~`'~~G D.G. My Commission ~xpir~s '
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