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Declaration ot Domicile and Citizenship 1~4~?54
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl, IUCIE COUNTY, FIORIDA:
This is my declarotion of Domicile and Citizenship in thq Siate of Flo~ida that I am filing this day in acaordanoe and
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
Wilmington N. C.
I was fo~merly a legal resident of
(City) (State)
and i resided at Rightsville Sound Trailer COUrt ~~vechanged my domiCile
(Street and Numbe~)
ro and am and have been a bona ficle resident of the State of Florids since Feb. 7 day of
, ~968 , and ~ reside at 110 Imperial way, Bel Air Bstates
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be take~ as my declaration of citizenship, actual legal residente and domicile in the State of Hotida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
for homestead purposes
FIlEO ANO RECORDED`
ST. LUCIE COUNTY. FLa.
RFCQR~ V~RIFIED
1'74'754
' '69 FE6 13 PM !2: I
i y~
R ~oi7Ras
i
€ CLERK CIRCUlT COURT
I Ft1RTHER CERTIFY that I will compty with all other requiremenri of a lepal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my fomner domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
/
(Na~) James B. Stailings
• : iF: 1
. '''~I~
` 'j~ (Address)
. . F;-~ •
. - .
_`'~iKom to a~.lsGbscribed before me this 13 day of ~z~ Februarv ,~q 69 ,
-t
, i~~ " r,~-,'
ROGERt POITRAS
CLERK CIRCUR COURT Notary Public
6y ~ D.C. My Gommiuion expires
(To b~ ~x~cui~d in daplicNe and ori~ina! fil~e! whh Clselc CirwN Court, and duplicaN witb Tax Atsasor.l
,3 eooK~~J ~c~2~Q
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