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HomeMy WebLinkAbout0145 y~ For~ E. T. GlOl-D-l60ll-~~i7) Declorotion of Domicile and Citizenship TO TIiE 3TATE AND COUNTY TAR A38ESSOR~ . St. Luci• CpvI~1'ry. Fl,pRIDA: Thia ia my declaration oi Domicile and Citisenahip in the State of Florida that I am fllin~ thia day in accordance. and in coniornaity with Chapter 222, Section 222.17, Flortda Statutes. I was iormerly a legal reaident of~_-_-:~.. Missoule __l9ontana------ - - (Ctq?) (state) and I resided at---4Z5.._Eest _ K~ Av~nu~ However~ I have changed my domicile (Street aad Nwnbes) to and am and have been a bona flde resident of the State of F1orlda since__ ~!~__l~t day of _____________________Ap~,il_______________~ 19Z~. and I reside at_4ot_26~81ock 2795L_L~t~ Circl~ - ' (Street and Number) Port St~ Luci~ ~ 8t. Luci• --------------------County?, Florida. ~City) and t~ia etatement ia to be taken as my declaration of citizenahip, actual legal residence and domicile in the State oi Florlda. ~ ~ (Luert 6ers any pertinent lacts, snch as ule oi~proparty or business. or relinqnubment oi employment st tosmer domicil0. t+mcval o! l~ib to new domicile. purel~aN a~ lwmi, ~t~) To •~tablieh l~qal r~sidsnc• in th• 8tat~.ot Florida. 226'769 i~~lUC1E COUNTY FI,A- ROCER POITRAS ~ RECORO VERt~FIED COU A!R ~I 4 39 P~1'~Z ; , ~ ~ ~ l ~ ~ ~ ~ I FUR.TIiE~t CERTIFY that I will regiater at my local addreaa when the regiatration booka reopen. and comply with all other requirements oi a legal reaident of this 3tate. I FURTHER CE~tTIFY that I have no intention to return to my former domicile, and I intend to remain ~ i~ Port St.. Luci• St. Luai• ---Countq, Florida, ~ ~~ti~ JOHA a. GRI~'~'ITH JR ~ permanently. f . • . ~ ~ - - ( N ~ i ~ . • - l` V ~ t ' ' - - - --?.fi?---81Q~k~795. L~rman Circi~-- : ~ y F . ..i S ~ : ~ (Addtess) ~ Swor~ xo aad ~qbe,~r~d~before me thia_ 4th_day oi _ ~_~:~~,~,f~:~.~._ A. D. 19_ 72 , ' } , lerk Circuit Court , . Deputy C1erY St. Zueie •Count~ l~loride ~ (To be executed in dnplic~eau~~,~[nal llled~w~h~Clerk Circuit Court. and dnplicate with Tax As~easor) BOOK UZ PAGE 4 ~V`~ ; . . . . • . . . _ r~~ . j =r- ~~~a+c~''~`.:S``~`- ~4 _ Y ~ •