HomeMy WebLinkAbout1876 Dectaration of Domicile and Citizenship
~4'~028
TO TtiL' STATE AnU COUNTY TAX ASSESS~R,
St. Lucie ~ CUUNTY, FLORIDA:
This is my decla~ation ot' Domicile and Citirenstiip in the State of Florida that I am filing this day in
accordan~e, and in coniormity with Section _'"'~.17, Florida Statutes.
I was formeriy a lrgal resident of Rochester Indiana and I
lci~r 1 (sace)
r~sided at _.Rt S__ Box 20 Lot _56 However, 1 have changed my domiciie to
(Street and Number)
and am and . have txen a bona fid~ resident of the State of Florida since day of ~
Au~ust i__ , ~q_ 70 and I res;de ac __109 Germani Drive White City ~
(Street and Number) i
Ft.. Pierce St. Lucie 4
- County, Florida, i
(c~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Insrr, herr any prrtinrot facts, such as salr of proprrty or business, w relinquishment of employment at former
domicile, remo~•al of familp to new domicile, purchase ot home, rte.)
Establishing residence and entering child in schoo~
2g~o2 '
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St~O a4~ RE `
1iCiC CQ~Kri
p06EA Pp~tR~~
RECOR~ y~~ CO~T
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t FURTHER CERTIFY that I will register at my local address when the registration books reopen, and ~
comply with all other requirements af a legal resident of this St3te.
1 FURTHER CFRTIFY that { have no intention to return to my fom~er domicile, and I intend to remain in ~
~
Ft. Pierce st. Lucie
Flo~,~,~^ nermanently. ~c~cy.~__------------. County,
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: u (Name)
_ anet Collins ~
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<~rn~tp.aqid,subscribed before me this ____1_.____ day of
~ ; ~
•~~r,.,.;., . .
Feb.------- A.D. 19--- --73
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Notaty Public State Of Flurida at Large ' ~ ~
Wy Commission expi es_~~-c~-~r_~ _ 1_5 11~ ~
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(To t~ rarculed in duplicate anJ un~tuial filyd wuh Ckrk Circuit Court. and duplicate ~+ith Tax Assessot)
. ~~210 ~~~1874
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