HomeMy WebLinkAbout1874 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
51. IUCIE COUNTY, FlORIOA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in atcordance and
in confo~mity with Chapte~ 222, Section 222.17, Flo~ida Statutes.
Statten Island New York
I was formerly a legal resident of ~ . - -
~C;ty~ (State)
87 Chandler Avenue
a~d 1 resided at However 1 have changed my domicjle
(Street and Number)
to and am and have been a bona fide reside~t of the State of Florida since Feb 11 day of
_ , t9
?0 , and I res~de ar ?02 Garden Avenue _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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 facts, such as sale of propery or business, or relinquishrrtent of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residency
FIIED AND RECORDEO
S''. LUCIE COUNTY, FLA.
~?~COP.^ :'~R1=;ED
1934 :8
. 'T0 MAY I 8 AM ! I: 0 7
~ - F~~F? : 01?RAS~r~
~ CLEP,K CIRCUIT COURT`
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I FURTHER CERTIFY that I wil) comply with all other requirements of a(egal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiCi~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
~ ~ a~~ [r
~ (Name) David ~ SimoIIs
~
~
i~~
(Address)
~ .
n~ ~,;?t t:: :rr;
~ , , 18 l~ay ?0
• ~:,5~com't~.'aird subscribed before me this day of . 19 •
i ;;z' -..:.r:'ti-,
~ i: '
~ ,.i;~[~~i~f~
~ - =~K'G~CJiIf COURT Notary Public
~ ~~I~ a~? O.C. M Commission ex ires
By ,^r:-.~.,L~ ; ~ Y P
~
~ (To b~ ~xecuted in duplicat~ and original filed witl~ Cle~lc Grcuit Courf, ae~d duplica» with T~x AssKSO~.)
~ 0 R Q
B00!(~~4 P~18 rU
No. t 3
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