HomeMy WebLinkAbout0178 D~claratio~ o!. Domi~il~ a~d CitisMShip
TO THE STATE ANO COUNTY TAX ASSESSOR.
Sl. LUCIE COUNTY, FlOR1~A: ~
~ This is my decia~ation of Oomicife and ~itizenship in ths State of Florida Mat 1 am filin~ this day in aooord~nce and
in confo~miry with Chapter 222, Section Z22.17, Florida Ststutes.
1 was fo~me~iy a legal ~esident of ~e~ue S9IItualO/
' (City) (State)
ar~d 1 resided at C~ Street However 1 have chanyed my domiti~e in
(St~eet and Number)
tbat I a~ nov an~ einas 23 llov 9P haie bssn on sctivs dat~ vith tbe AS~A~. Upon rstiring
~
irot said acti~s asrvias, I s~act and intencl to bs • bona fide resident o! the 3tate of
F-7.o~siday-$nd to ~ rosi~ 1~~ia ~ 663,
S"J'~iD-~ C~2~dD~•~~i tStraet and Num D) ~s2
Part Ssint Lucie, ~ • ~Q ~
SAINT LUCIE COUNTY, RORIDA
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 fads, such as sale of property or business, or relinquishment of emptoyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
TTpon my entrawce onto active dnty xith the D5 Ar~qr in 1959, I~~f~
teiainated au~y actunl or realiatice rssidence in ths Stats of Esntncl~. Sincs .
that tiae, I have been etationsd in difterent parta o! tbs ~rorld and in
ditferent atates in the co~inental IInited States.
~ On 14 dP~ 19~10 I pwrcbnsea certain ~eal pTOpsrt7 in the State of -
Florida, describsa as Lot-~ 14, Bloclc ~ 663, Fbi''t Saint•Lncie, Saiat Lucie
County, Florida. It is ~ intent~.on to establish sat persanent dc~icile
an~d re4ldence in the 3tate of lrlorids when I retirs h~oa sotive dnt~ vith
~ . FIlEO AND RECORDED
ST. ~UCIE COVNTY, FLA.
G~~~;~.r, ~,J~ RlFIED
~ ~965i9
~ ~'TO Jl~l 28 AN . I i: 56 .
~ ~ `
c~~r_.~t? t~OITR!',
~ CL£RK ClRCUIT COUR •
I FURTHER CERTIFY that I will oomply witfi all other raquirements of a lepa) resitlent of this State.
_ P~!
I FURTHER CERTiFY that I have no intention to return to my former domicile, and I i tend to remain in ~
SAIIR LDCIE, - .
SAINT IUCIE COUNTY, FLORIDA, permanently. - .
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; ~ a.Y~,~';,_,;`
Jack WWame) Lid_~_,-~ ~;~~U:• =
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(Address).•: :..c :
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2 th J , . 7p
Swom to and subscribed before me this 4 day of ~ ~+-f , 19
` _ ~
ROGER PORRAS
CLERK CIRCUIT COURT Notary Pu '
Sy D.C: My Commission expires 28 ~g• 1973
Ro b~ ~x~cvhd in dupl~ut~ and ori~inal ~il~d with ~rk Geruit Courf, and duplicah wilh Tax Aa~ssor.)
BOOx 1~ PAGE
No. 13
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