HomeMy WebLinkAbout1742 O~al~~atio~ ot Don~lail~ and CftlsMShip
TO THE STATE AND GOUNTY TAX ASSESSOR. 2~34~
Sl. LUCIE COUNTY. FIORIDA:
This is my declaration of Domicils and Citiu~ship in th~ St~te of Florid~ th~t 1 am filinq this d~y i~ ~ooord~na ~nd
~n eonformity with Chapte~ 222, Section 222.17, Horida Statut~s.
1 was forme~ly a le9al resident of ~,:~.~-f.~'~A••~p ,~~-~~3•~l~~-*~
(City) ~ (Stat~)
and 1 resided et Howev~r 1 have th~nqed my domiCile
(Sneet and Numbe~) ~
to and am and have been a bona fide resident of the Ststs of Florida since dVo v. ~Y
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. 19 and 1 roside at 3 S c~ n. ~t. 1' c C~ c- ~,t> _
(Straet ~nd Number)
FORT r1~CE, SAfNT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citize~ship, actual legal ~esidence and domicile in ths Stsro of Horida.
(Insert here any pertinent facts, such as sale of property or bu:iness, or relinquishment of employment
at forme~ domicile, removal of family fo new domicile, purthase of tame, etc.)
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til~CA1E COUMT~ftA.
CLER~C RCU T pUpj~~,~ ~
RECORO YER~FIEO~..~~~~ -
~ Ja~ 19 112a PH't I
2C~3496
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I fURTHER CHtTIFY that I will eomply with all other requirements of a(e~) residsnt of this Stats.
I FURTHER CERTIFY that 1 have no intention b return to my former domicjle, and 1 intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ (Name) D ~c/~
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SMi~ocn:to_~;'~~,uibed before me this ~ day of , 19.~
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~ ~Q~CI~CUR C Notsry Public
~ 8y ~ D.C. My Gommis:ion expires
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(To b~ ~x~eut~d in duplicah and oripinal fil~d whh Clwlc praif Couet, and dupliaN whl~ Tax AsN~x.)
„ g~R~~89 ~~1737 ~
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