HomeMy WebLinkAbout1870 . . . . . . ~
Decl~rat~on of Domicile and Citizens~~p
'I`O 'I~l 1!: S1~AT1: AND CUUN7'Y TAX ASSI:SSOR, ~ra~~s
_ ST. LUCIE` ~ COUNTY, FLORIUA: '
,
77ii. is my drelaratiun of Domirilr an~l Citizcnship in thc Statc of Flatida that 1 am tiling this day in ;
accordancc, and in confonnity with Section 222. i 7, Florida Statutes.
1 was formcrly a Icgal resident of ~ ,,~9~~-// , and I
' (c~tr) (staee) `
r~>i~i1 d~ Gu''~ ~~Y~~~ . However, I have changed my domicile to '
(Street and Numbr~)
and am and have been a bona tide re:sident of the State of Florida since day of
, 19______y and I reside at
~~C~ . (Street and Number) !
s
St. Lucie County, Florida, ~
(c~cy)
and tl~is statement is to be taken as my declaration of citizenship, actual lega~ residence and domicile in the State
of Florida.
(Insert he~e any pertinent tacts, such u sale of property or business, w relinquishment of employment at fotmet
dumicile, rcmoval of family to new domicile, pu~chase ot home, etc.)
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CLERK ~1=>~~~T C~URT
oc~1;~: Y~ :~ilED
~yq, t8 I~ 36 PM'73
j 25941.$
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I FURTNf:R CERTIFY that 1 will register at my local address when the registration books reopen, and
~ comply with all other requirements of a legal resident of this State.
~
~ I FURTHCR CERTIFY that [ have no inte»tion to return to my former domicile, and 1 intend to remain in
~ _ St . Lucie
' Co nty, ~
' Florida, pcrn~ancntly. (c~~r) ~C f'~7fliNYi N G~ '
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? {;:...1:~. ~ (Name)
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_ C-~ ~ %~v~ r . • ' (Address)
. 3'. i .,~4 = '-'•i!",'-:~~3 .
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~~ocrtk:~c~ :~d suh'scc'tfie~~fii;forc ~r.~~ this d~y of
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. ~ .r~-_~-~-~--------- - A.D. 19.~~. ~Sy~-y~ fj~a ~ ''~~~~ti~
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~ _ ~ ~JCLERK OF IRCUIT COURT
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' (To be carrutrJ in dupbr~le anJ ~~nym.d filyd w~lh ('lerk l'itcuit ('ourl. anJ duplkate kith Tax A~ac~soi) ~
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