HomeMy WebLinkAbout1574 'l86'?'~'i
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To the Stote ond Couny Tox Assessor, ,
_ .:.UCIE ~l(KRCN COUNTY~ FLORIDA ~
This is my ~eclaratio~ of Oornicile and Citizenship in the $tote of Florido that I am filing
i
this doy in occordonce, und in confo~mity with $ection 222.17, Florido Stotutes, as amended by
CF,apter 26896, Lows of 1951.
I wos formerly o legol resident of __Whi te_ Plains New York
c~b srut.
and 1 resided at _?5 _Cobb Avenue L___ White Plains,__ New Yor)e
sneet ond Ph,rnM~ said crty ona srore {
However, ! have chonged my Domicile to and am and have been a bona fide resident of the Stote
of Floridu since ---------------tYl~_4f;YL-- doY of ----_Aecsm~er------- 19(~_5~ . ;
and I reside at _ 2870 _S. E. _San Jeroni~ _~3~.,___p9~.t_5~.._Luci.z,__~t.._l.ucie ~
sr.eet ond Numbs. C~rr eo~.nry
County, Florida, und this statement is to be taken as my Declaration of Ciiizenship, actuol lego!
residence and domicile in the State of Florido. (I nsert here any pertinent facts, such os sole of
property or business; or relinquishment of employment at former domicile, removal of family to
new domicile, purchose of home, etc.)
__Reti~ed _from _law _firm_ in _New _Yorle i_sol3_home_ i:-~_W~~g_ P~~i~s
__moved_ famil~r_and _furni~u~~_t~ ~l~x.id~_gvr.~ha~ed_n~ec_r~.~.id~nce__
FtLED AND RECORDED'
ST. LUCIE COUNTY F A
--at -a~9Y_~._~Sis~Ces~..------------------ cT ~'S
v~: : 6ll~N ~~f CD-'
- ~ -
- - - _
~fi'74~-------
---'69 _0~~---9--~--~ ~ ~1-- ~
f~~~~?- r'•01 i RAS
I~urther Certify ihot 1 wil! register ot m~~'~~ ~~~~rTiv~it~tU~~~ registrotion books ~eopen,
ond comply with all other requirements of a legol resident of this State.
I Further Certify thot I have no intention to retum to my~ former domicile, ond 1 intend to
- Porz St. Lucie, St. Lucie
remoin in
~;tr c«,nfr
Florido, permanently.
nee------
ame s M. Name - Husbond S
-----~r~ - --.~/..~22~~--------------
MarietteName - Wife Snee '
s-'~~~
Sworn to ond subscribed before me this __Y day WAR VETERANS - AU. WARS
of - ---~I1s.~ - 1',~69-. • Ple:se Check
E 1 - Spanish American ~
t fir~y Public or other Official taking Acknowledgment
' ~ 2 - Wortd War 1 ~
O
j~ Notary Pub1'x, State of f{orida at luqe
, ~ mission expirqwy{~,~,~~saa-ExpicesDec_]b.~412._
~b~ y y" b. e. e a~.. F:. a c..~.. ~ n u. 3- World W
a r II
~ ~ v} ~ /y 4 - Korean Conflitt
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` ~oVlc~.~~ ~E~~ i~ O t
a~ 5 - None ~ ~
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