HomeMy WebLinkAbout1474 Declaration ot Domicil• and Citiz~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA: •
This ia my detlaration of ~omicile and Citizenship in the State of Flaida that I am fili~y this day in aooo~danoe and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of Ch1C8$O I111IIOi8
(~itY) (Sfate)
and I resided at l~'~~_~ptt~~Tptd1~'..k 1Y811u~ . Howevar 1 have chanqed my domicjle
(Street arx! Numbe~)
to and am and have been a bona fide ~esident of the State of Florida since day of
Nayember , t9~~, and I reside at Villa del Sol Apt. D. . 8t. #~1 L
Hutchinson Island, Jensen Beach, Florida 33457 ~h°e~ snd Number)
FORT MERCE, SAINT LUCIE COUNTY, FLORIDA
antl this statement is to be taken as my declaration of citizenship, actual lega) residente and domitile in fhe State of Florida.
(lnsert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new dor~icile, purchsse of home, etc.)
Homestead
ST~~UC E C UNTY FLA, :
RE.CORD V~R~FlEp
19320~
~ 'TO MAY I I AN !0: I
! ko~'~ ~s
~ CLERK CIRCU COURT; •
~
~
!
1 FURTHER CEitTIFY that I will oomply with all other roquirements of a le~sl ~esident of tfib Stat~.
I FURTHER CERTIFY that I have no i~tention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. t
xu8 ii Z. zai a ~
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````~~.~~«~et~,q i~~;~`,, _
~1. R 0 .~'ai, ~ • ~ . (Name)
~`P~~~~~~~~~~~•: ^n/~` ~ ` .
~ ~ " . ` ~ i~~1 y _
~ O~ ~ ' = ~ ` Villa del Sol - Hutchinson Island
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~ - = ~ . ou e ~~~s) eneen eac , a.
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~ QUv _ . .
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~ ~-~vof,n~`~nd subxribed before me this llth day of , 1970 .
~
LU.
~ ROGER rOITRAS
s~ CIERK CIRCUR COURT Notery Public
~
By D.C. My Commiuion expires ~ ~
~ Ro b~ ~x~cuhd in dvpliuts and orioinal Rl~d with C~ek prwit Cour~, and dupliuN witb Tax A~s~or,1
~ OR
~ ,3 a~184 ~1472
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