HomeMy WebLinkAbout1942 Deci~ration ot Dort~ic~le artd Citizenship
TO TNE $TATE ANO COUNTY TAX ASSESSOR.
213691
~ i LUCtf COUNTY, FIORIDA
Th~s ~s my dec!aratcon of ~om~u~e and Cit~zenship ~n the State of Florida that I am fil~ng th~s day ~n accordance and
n conform;ty w~th Chapter ??2, Sect~on ?22.17, Fiorida Statutes.
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t was formerly a tegal res~dent of a~ ~'F'C~ S_--
(Ciry) ~ (State)
a~d 1 res~ded at ? •%'~-S` Howeve~ 1 have changed my domiCite
(Street and Number)
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•o and am ar.d have been a bo~~a f~de resident of the State of Flo?ida since `~~t s~'"` _ day of
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- ~ ~ , 19_ ^ ~ , and I re~ide at • ~i ~ ~ ' F_/~s~ ~~F •
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
~~d th~s statement +s *o be raken as my d~claration of citizenship, actual lega! residence and domicile in the State ot Florida.
(lnsert here any pert~nent facts, such as sate of property or business, or relinquishment of employment
at farmer dom~c~le, removal of family to new domicile, purchase of home, etc.)
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fJLED ~y0 RE~GROE~
;1. ~liClt COUMTr iL~.
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Au~ I I 3~ PM'11
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~ 213691 ~
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i FURTHER C'EitTIFY that I will comply with all other requirements of a legal resident of this State.
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I FURTHER CERTIFY that I have no inte~tion to return to my former domic,ile, and I intend to remain in FORT
=:~RCE, SAiNT «~IE COUNTY, FLORlUA, permanently.
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(Address)
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~ Sviror~ b and subscnbed before me this ~ _ _ _ day of (~.~:~.tr:~..s.~. _ _ 19 ~
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~ ito~~t tcxntl's
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~ C~T COURT Notary Public
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3y ~ ~ ~y~'. ~ _ ~_C My Commission expires
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~ Ro b~ ~:~cvhd in dupliut~ and ori~inal fil~d with Cl~rk Grcuit Court, and duRliwt~ with Tax Asses~or.) -
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