HomeMy WebLinkAbout1779 Declar~alion ot Domicile and Citisenship 1?~4~2~
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TO THE STATE ANO COUNTY TAX ASSESSOR. ~
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Sl. WCIE COUNTY, FLORIDA: ~
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This is my declaration of Domicile and Gitizenship in the State of Florida that I am filing this day in acoordanoe and ~
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in conformity with Chapter 222, Section 222.17, Florida Statutes. j
I was formerly a legal resident of DECATUR ILLINOIS
(City) (State)
1249 WEST GRHEN STREBT . However I have cha m domiCl~e
and I resided at ~9~ Y
(Street and Number)
to and am and have bee~ a bona fide resident of the State of Florida since lOth day of
MqY 6 8 ~
, 19 , and I reside af 1 dnQ CnifTH 77th STRRRT FT PT FR(`F Fi e~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declarotion of citize~ship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or busineu, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
HOMESTEAD PURPOSES
F~l.EO ANO RECOROEO'
ST. LUCIE COUNTY, FLa ~
n~COR!? VERI~tED i
1`?'442;~ ~
'69 FE6 3 PM I: 2y ~
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~'01TRAS '
CIERK CtRCU1T COURT E
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently:
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~ ~ ~ (Name) ,
- CHARLES R. KAY
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~z . 1409 SOVrH 27th,st.,FT.PIERCE,FI.A. ;
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• , . (Address)
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V .•ti~JS~~~~•
- ','~`~s : , ;
~ ~ , 3rd FEBRL'ARY , 19 69
Swoie~:tq and,&~bscribed before me this day of •
- ROGER POITRAS
iRCU1T COURT Notary Public '
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By D.C. My Commission expires
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(To b..xecwed in dupliut. and ori~ina! fl.d witb Cl.rlc Gra,it Court, and duplicat~ with Tsx A~stor.) ~
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