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Declaration ot Domic~le and Citlzenship
TO THE STATE AND COUNTY TAX ASSESSOR, '
1~3E~8~ ~
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in tha State of Florida that I am filing this dsy in accordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal ~esident of C0~18 Illinois _ (
(Ciy) (StaM) t
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and I resided at _ 1167 11Arpn St . However 1 have changed my domiGle ~
(Street and Number)
to a~d am and have been a bona fide resident of the State of Florida since lst day of •
. ~
-__~gy , 19.ZSZ, and I reside at 802 Delswate Ave. ~ Ft. PieY'Ce ~ Fla. ~
(Street and Number) ;
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FORT PIERGE, SAINT LUCIE COUNTY, RORIDA `
and this statement is to be taken as my declaration of citi=enship, actual lega) residence a~d domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employReent
at former domicile, removal of family to r?ew domicile, purchase of home, etc.)
/JR.
RAYMORD A. HAMIZTON 9yrs age ~
- F~L.ED nvD RECORDED '
SIIANNOA G. HAmILTOA 8yrs age SY. LUCtE COUNTY, FLA. +
^n:~~ ~~~ql~'~Li ~
DIISTOA J. HAMIZTON 7yra age 1~3~89
'10 f~f'~Y 2I 10: 53
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1~~!~t~?:.S
CLERK CiRCUIT COURT
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~ I FURTHER CERTIFY ihat 1 will comply with all other requirements of a leyal resident of this State. ~
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I FURTHER CERTlFY that 1 have no intention to return to my fo domic.ile, and I intend to remain in FORT ;
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. • ;
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08D . HAl[ILTOB
(Name) j
;f.;';:~ :
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l:,i~:.?r'
~ U~-,: 842 Delaware Ave., Ft. Pieree, Fla. ;
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~ - . ~ ~ ~l -~t ' _ (Address)
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~ ~.$w~~i~.far~d~~~r~ed before me this 21$t day of 19~.
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~ CLERI~ lRC~l1 COURT Notary Public
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~ 8y D.C. My Commisaion expires ~
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(To b~ ~x~cuted in dupliuts snd oripinst filsd with Ci~lc GnuM Cour~, and duplieat~ with Tax Aas~ssor.) ~
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