HomeMy WebLinkAbout2784 Oeclaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~ ~ I SW4 ~
Sl. IUCIE COUNTY, FLORIOA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in acoordence and
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a lega) resident of New York City I~ Y
(City) (State)
ar~d 1 resided at _ 511 We S t 23 S S t ree t , Hcwever 1 have changed my domicile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 17th day of
February____ ,~9
69, and 1 reside ar 1512'~ Havanna Ave. E
(Sheet and Number) ~
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FORT MERCE, SAINT LUCIE COUNTY, RORIDA i
and this statement is to be taken as my declaration of citizenship, actual iegal residence and domicile in the State of Horida. ~
(Insert here any pertinent fads, such as sale of property or busineu, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Entering Allen Mour, :d in the 9th grade of school
i
= %~r~'D ~ECGR~EC
S i~. ~tJi,l~ COUNTY. ^l.•i.
RECORO V~RIFI~_; ;
, i;~9 F~ 34 • i
a~ ~.ry
!?CGER AOITR~`~;, '7~
CIERK ClP,CUIT COURT
` ' :1`75~?64
E!
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I FURTHER CERT.~Y that I will comply with all other requirements of a legal resident of this State. ~
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I FURTHER CERTIFY that I have no intention to retum to my former dcxnicjle, and I intend to remain in FORT
PIERCE, SA~NT LUCIE COUNTY, FLORIDA, permanently.
;~'~~~=...`Gc,.,_ F - ~~~c~c~i ~'yl c~.--~-o~-
. ;
r - ; • . ' iEf ~"se#.`;
_ " ~ ~ . . t j = ~ I _ _ ~ ~ (Name
- - ~ - Evelyn Mound
- . ' ' ' - ~ ;
_ ~
- (Address) E
~ .~c. .
Sworn to and suburibed before me this 24th day of FeU. , ~q 69
ROGER rO1TRAS
CIRCUIT URT Notary Public i
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8y a'`'~'~ O.C. My Commission expi~es
t
(To b~ ~x~hd In dvplical~ and aioi~al fil~d with Cl~k Cie~if Cou~f, and duplicat~ wiN~ Tax AsNwa.1
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~ ~cRK 175 Y~cE2~~30
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