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Oeclaration ot Domicile and Citizenship 18S'~~2 ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my declarotion of Oomicile and Citize~ship in the State of Florida that I am filing this day in attordsnte and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _~~etsr~ll~ Pt. _
~City) (State)
and I resided at -_,_Rt. ~2, BpY ~X ~s However 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 22Dd day of i
~
~
Deceab~r_____ , 19 69, and I reside ar 60b So. Z~tb. Street ;
(St~eet and Number) ii
i
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Horida.
1
(Insert here any perti~ent fads, such as sale of property or business, or ?elinquishment of employment '
at former domicile, remova) of family to new domicile, purchase of home, etc.) ~
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Homestead and reaidence
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3 I FURTHER CERTIFY that I will comply witfi all other requirements of a(eyal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my fo~mer domiGle, and I intend to remain in FORT
~ PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently.
~ ~i-~,~.'G~~.~-~'
~ WILLIAI! TOUD SR
~ . .
~ (Name)
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~ 606 30. 24th. Street~ Pt. p.
' (Address)
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a iU~;t~tst:r~.,
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~ ~~'~i'.Slwom•to~al~~~jiubsuibed before me this Z3rd day of Januarlr , ~q 70 ,
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- ' ~ ~ ~,l~~y~itt~s-
~ - : ~ ~ .CtERK REt11T ~lRT Notary Publ ic
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~ By" ~ D.C. My Commission expirea
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~ • . . .
~ t~.t„~~t .
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~ Ro b~ ~xecuted in duplicat~ snd ori~inal fil~d whh Cl~rk Circuit Cou~f, and duplicst~ with Tax Ass~swr.)
~ k 1~~ ~~E 1241
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