HomeMy WebLinkAbout1461 i91031 ;
Declaratio~ of Domicile and Citizenship ,
,
TO THE STATE AN~ COUNTY TAX ASSESSOR, ;
Sl. LUCIE COUNTY, FLORIDA: ;
This is my declaration or ?;omiciie arod Citizenship in the State of Florida +hat I am filinfl this day in aocordance anc!
~n conformity with Chapter 222, Section 222.17, Ftor'sda Statutes.
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I was fo~meriy a leqal ~esident of ~int`r HflVeD Flfl .
(City) (State)
and I resided at ~ 401 ~ve . E. N. E . However 1 have chan~ed my domirjla
(Street and Numbe~)
to and am and have been a bona fide ~esident of the State of Florida since ~th day of
e~~~~, , 19_.b~, and 1 reside at 2913 Sherwood I,ane
(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my decla~a~i~n of citizenahip, actval legal residence and domicile in the State of Hotida.
-(Insert here any pertinent facts, sucf~ as sale of property or busineu, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of home, etc.)
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residence
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' <UCI~ RE~OR
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E 1 RJRTHfR-~~RTiFY-thati wiit-aampty witfi a1t-otharreqvi~ements-af a Iegal~resideM of this Stab:
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; I FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIOA, permanently. -
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~ . CAI,VIN R. TRIPLETT ~
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; (Name)
:
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~ - . - « Y$t~c~ 2913 Sherwood I,sne
; ~ -,i ; . . (Address) !
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: ~ ~~1tt1~ul1,;l~f • i
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~ ``;~tA'to;~'~1d su~schbed Eiefore me this 12th day ot ~8reh , 19 70 . '
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f -N'!~LE~(E'~Ii~CU ~ Q04t~- Notary Public ;
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By D.C. My Gommis:'wn expires t
~ ' ~k•''~~, r~ai11?~~~~~~` ~ '
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(To b~ exocuted in duplicat~ snd o OgR with cuit Court, snd dupliat~ with 7ax Ass~ssor.) :
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