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------ -
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(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~
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' (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
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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
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