HomeMy WebLinkAbout1285 . ~
. ~
O~Iuat1011 Of OOf111C11! J111d ~'i1~liM~h~p
TO TNE STATE AN~ COUNTY TAX MSSESSOR.
sT. wC~E cOUHnr, aoRia~?:
Thi~ is m~r d~cle~ation of Oomicil~ ~nd Glti~tlth~p in fh~ St~N of fiotida thaf 1~tn filin~ fhis day in aooordano~ and
in con_formity with Chaphr.~2Z. S~ttion 2Z2.17, fbtida~Shtut~.
i W~, ~„~~y ~ i~,~ ~ Port Orahard ~aehingtoa
QCtry) ~ ~Stats)
snd ~~s'~d~d ~t ~ 8t 3 Bo= 5 _ How~wr ~ haw cha+p«! my domidl~ _
tStrNt and t~uir+bK) .
ro and am and haw bNn a bona fid~ ntidMt of ths Stat~ of fiorida sino~ lat day d
Au~uet , tq 70 a~ ~ xt 2, Bo: 2768C
lStrNt ~~+d Numb~?) -
lORT ~IQC~, tANrT lIK1E COUNTY, RORpA
snd this statsm~nt is ro be takM as my dsdantio~ of citi~ship, actud Ipai ~~id~nw and domidl~ in th~ Stata of Horida.
tlnsert hen~ any p~~tine~+t facts, wch as sal~ of propKty or bu:inas, vr relinqu~~hm~+t of ~mp{oymMt -
at former domicile, romoval of family to new domidl~, purchas~ of hornt, Nc.)
(School) .
Harry 11. IYeatoYer, Jr. - 12th arad• . ~
~ ~Ft~~ 'I~NO'
~ 8~. IUC~: COA~:~~;
. R~~~R~ VERIF'!Ep
, 70 • 1~~~
~us ~ 1~w ~ i. e0
;
~ ~ ROGER POITRAB
~ CLERK CIRCUtT COUR'~
! - .
_ I R1itTHER G~tTIFY Mat I w111 aoa~plr with all o1hK nquir~nrnb o# a Ipd n~id~M of thu Stat~.
1 FURTHER CERT1Flf that I have no in»ntion to retum to my formK domidle. and 1 int~nd to nmain in FORT
PIERCE,_SAINT LUCIE COUNTY. fLOR10A, psrmans~tlY• HaZ'l~y w AeBto~'er .
. _ jf ,
Utidd~)
Ao ~ ~b~d bsfor~ m~ this 17 th day af d~ ~ t . 19 .
~~~c' ' .
T ~~~~'y ~ .
~ , .
Z'~ ~ , Notary Publk
_ r .r~;,. j _
~
e~? , - - o.c. My co~so~+ .~p~«
~ ~ +in • t` :
' i 1/ i1~ ~ f~'• : . .
• J :
R~ , , a~i «i~t~at ~1 wMi~ Cl~ie Cl~i~ Gw~ a~i ~Mw~ wiN~ Tac A~rJ . .
R ~,86 ~1283 - ~
. - . go~K
Ns. 1i - '
- - ~ ~ - r`