HomeMy WebLinkAbout1785 ~ Deciaratlon ot Domicile and Citisenship
TO TNE STATE AND COUNTY TAX ASSESSOR, ~~"`~~2
51. LUCIE COUNTY, FlORIDA:
i
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day i~ atcordance and +
in confo~mity with Chapter 222, Section ?22.17, Florida Statutes. '
1 was formerty a legal resident o.` Oratlge Coun~_ _ Vtrainia j
(City) (Stab)
and I resided at R F D 1` Barbouraville 22923 _ ~,,,,g„~ ~ havechanged my domic~le
(St~eet and Number)
to and am and have been a bona fide resident of the State of Ftorida since lat day of ,
Holiday Oat inAmerica ~
_ NO~?lmbtr , ~q69 , and I reside at _ Rt 1 Jensen BC ~ Fl~. '
(Street and Number)
FORT PIERCE, SAlNT LUClE COUNTY, FLORIDA
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida. ;
;
(Insert here any pertinent fatts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of famiiy to new ~micile, purchase of home, etc.)
Bstablisbing residence
Fl~ED AND RECORDED
ST, LUCIE COUNTY. FLA.
~ECOR~ V~Rl~r~p `
;
186gy;~
'69 DEC ! PM 2 56
-~'k FOlTRAg
C~ERK CtRCUtT COURT
1 RIRTHER CERTIFY that I will comply with all other requirementa of a legal resident of this State.
. I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
P(ERCE, sarNr~~~fC4~,•iCOUNTY, FLORtDA, permanently. #
_ ~ ~ i
~7 r' 1
- ~ l ~
; ~ " (Name) ~
' = = Thstche~ Adama
. • .^.r ~``ti ` .
< - ' ~ y ~~r~c.
' ~ ~
. Ruth Adams
69
Sworn to and subscribed before me this 11 day of - ~~el~ber , tq____~~X
ROGER POITRAS ~
LERK CtRCUIT COURT Notary Public +
..c~.~.C.t~C ~
BY ~ ~ D.C. My Commission expires ~
Ro be executad in dupliuh and oripinsl Rlsd witfi Gerk Grcuit Court, and duplicat~ with Tax Ass~s~or.)
so~181 ~E1~8~
t~o. 13
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