HomeMy WebLinkAbout0230 ~ 1901~~
Declaratio~ ot Domicite and Citisenghip .
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TO THE STATE AND COUNTY TAX ASSESSOR, ~
51. LUCIE ~OUNTY, FLORI~A:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 2~2, Section 422.17. Florida Statutes.
1 was formerly a legal resident of -QS~eQe Il~. _
(Ciy) (State)
and I resided at -~Q~ VAi n St. r _ However I have changed my domiGle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 15
th day of
, 19~._, and 1 reside at 13~ St• I+uCi@ L811@
1~~ (Sireet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my dectarotion of citizenship, actual tegal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, o~ relinquishm~nt of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Re3ldence '
~ FILED A~tD RECORDED ~
_T. ~~C!r : ~ U,".TY, F± :
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I FURTHER CERTIFY that I will~ comply with al) other requirements of a le~al resident of this Stafe. ~
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I~ RTH R R that I hav n intention to return to m formet' domicjle, and I intend to remain in FORT ~
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ /~~i`~/'
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~ yrj,IF. W. B : Alt
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(Name)
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~ :`~,,-;;~~t~~~:rn,,,,~~ „ , 135 St. LuCie Lane
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O 'i (Address)
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- ~ ~ a 23rd February ~q TO
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a sn6spr~~b' ed before me this day of . •
-`~~~;,~;~r'yt~~'~:
i;A~ - . . { ~a ~.f '4's~
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~ 1 .~RT Notary Public
'~~,ns. i >>l .
;wf_ ' l1111i1 ~
gy D.C. My Commission expires
(T~ bs ~xscuted in duplica~e snd oriyinal fil~d whh C1~rlc Circuit Court, and duplicst~ with Tax Ass~s~.)
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BOOK ~8~7 PAGE ~3O
Ne. 13 _ , _ . .
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