HomeMy WebLinkAbout1603 DeClaration ot DomiCile and Citizenship 2~559
Tv T~iE S~ATE RND ~~:;!+:TY ?AX Aw€S..~G4, .
Sl. IUCIE COUNTY, FIORIDA. .
This ~s my declaration of Dom~cile and Cit~2ensh~p in the State of Florida that I am filing this day in accordance and
;n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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1 was fo~merly a legal resident of _ P~@__~~Q~~1 _~e~! .~graey
(C;ty) (State)
107 T,tlYrshe Drive However 1 have chan ed m domiCile
and 1 resided at _ _ _ _ - - - - - - 9 Y
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since 15t2'1 _ day of
October 19 ?1 1Q07 Cypreaa Ave.
. and I reside at _ _ _ _ _ _ _ - - -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual lega! residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of iamily to new domicile, purchase of home, etc.)
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Establi~+hing reaicence
221559
FIlEO ayp RECOR~ED
ST. lUC1E COtiNTY FIA.
ROGER POtTRAS
CIERK C.~Ctl~T COURT ;
RECQ~C Vr::~r;Fp~~~~
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% 1 FURTHER CH2TlFY that I will compty with all other requirements of a legal resider?t of this State.
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x 1 FURTHER CERTIFY that I have no intention to return to my former domiule, and 1 intend to remain in FORT
~ PlERCE, SAlNT LUCIE COUNTY, FLORIDA, permanently.
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C. ~~i~i~l2~~inc1
~ :.~,t, ._j.:.... C(~%~, (Name) -
` ~•'~J ~Iw'~~`.'`'~-=~ ' . '~tillia~ T. Hodum
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_ = t"~ # ~ ~~t~t~ " _ _ K' i f e
~ • Mildred E.
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'~S~wq~,T?,lpC.a d`subscribed before me this _ 5th day of _ ___Janu,ary ~ 19 72
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~ ROGER POITRAS _
;1CLERK CIRCUIT COURT Notary Public
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By _ D.C. My Commission expires
(To be exscvted in duplicale and original filed with Uerk Grcuif Court, and duplicate with Tax Assessor.)
~ F~ ,3 s~198 ~1601
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