HomeMy WebLinkAbout1840 ~ ~
i
Declaration ot Don~icile and Citize~ship ~
TO THE STATE AND COUNTY TAX ASSESSOR. 221~26
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
~
! was fo~merly a legal resident of -
~ (City) (State)
'
and I resided at _ _ - - _ - - . However 1 have changed my domiCile
(Street and Number)
to and am and have been a bo~a fide resident of the State of Florida since ~,~~1 1~ -~-l-LI day of •
/ ` ~
- - - - 19---, and I reside at f(v , ~~l ~/""w`r -
(Street and Number) ~
FORT PIERCE, SAINT LUCiE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal ~esidence and domicile in the State of Floricla.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
~ f IIED AN4 RECOa0E0
at.WC1E~
P~~RAS~~
E lEflK CI~~.CS~~ COt1itT
ltECQFG ~~°•tr1E~'
t ~2
. ~ ~ ~
~
~
:
~ zzs~~s
;
~
~
~
~
~ I FURTHER CH2TIFY that I wil! comply with sll other requirements of a leqal resident of this State.
~
~ I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
~ PIERC~,,.SJ,~1NT'tUCIE COUNTY, FLORIDA, permanently.
~ - - .
y ~~/J
~ . ~GCL d- ~~C~x~.~X.!'
~ (Name)
~ , A. ~
~ "
: . -
~ . ~ = 1~ $ ~1~,,~d,~,~ ~
. ;;,~~t (Address)
. _
- -
Sworn to and subscribed before me this day of , 19y1~
~ ,
~`3 ROGER POITRAS -
ClF.itK CIRCUIT COURT • Notary Public
~r
By N D.C. My Commission expires
~
(To bs ex~cutsd in dupliuts snd oriqinal ~il~d wifh Gt~c Grcuit Court, and duplicate with Tax Ass~ssor.)
~
~a;
Mo. 13 q OLtJ~~~
h '
~-t F~ `
~N.. s. . . ~ . ._.e._ _ ~,,._~-~^._'<i