HomeMy WebLinkAbout1660 De~laratio~ ot Domicile and Citizenship ,~84
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si, IUCIE COUNTY, FIORIDA:
This is my cleclarotion of Oomicile and Citizenship in ths State of Florida that 1 am filing this day in aooo?d~nos and
i~ conformiy with Cfiapter 222, Sectio~ 222.17. Florida Statutes. ~
1 was formerly a legal resi~ent of Ha~en penn
Kiy) (Sta»)
and 1 ~esided at 220 Second Ave. . However I hsve charped my domidfe
(St~set and Number)
ro and am snd have been a bona fide resident of the State of Florida since lit day of
September ,g$ , a~ i at 153 3~neta Court Port St. Lucie
(Street and Numbsr)
FORT MERCE, SAINT LIJCIE COUNTY, FLORIDA .
a~d this statement is to be taken as my declaration of citizenship, attual legal residenoe and domicile in the Sfste of Horida.
(tnsert here any pe~tinent facfs, such as sale of property or busineu, or relinquishment of employmant
at former +domicile, removal of family to new domicite, purchase af home, etc.)
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_ Bstabl.isbing resideoce ~ ~~~.Y~,~
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1 RJRTHER G~TIFY that I will oomply with all other requirement= of a lepal r~ids~t of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 int~nd to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
- ~ ~JIJ Wh~itw. Q l ~.J~f
- _ - , a:.• ~ ~a~,
~ Sandrs R. peters ( Mrs wm~
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t;' ~ , ~~v~~ (Nddress)
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~~~~~to and subsaibed before me this Zlat day of OCtObll ~ 19 69 .
~ p'OITRAS
CiRCU OURT Notary Public
gy at~ D.C. My Commission expires .
(Te bs ~c~cutad in duplicat~ and ori~in~ filsd whh q~ek qrcutt Coue~, and d~rpNcaN wilk Tax As~or.)
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