HomeMy WebLinkAbout1669 . H ~
De~~~ra~~~n of D~?micile and Citizenship
TO THIi STA~'G ANI) CUUNTY 7'AX ASS{=.SSOR, 265639
St.Lucic
~ COUN'1'1', f=LORlnA:
Tl~is is my dcclaratiun of Uomlcii4 and Citi•r.cnship in the Statc of Florida that I am fling this day in
accordance, and in conformity with Section 222.17, Florida. Statutes.
1 was fom~c;rly a lcgal residr•nt of M~ N R S S A S , 1/~ ~ • and 1
(Citr) (Stste)
resided at 8~° ~s ~ To ~ C w f} L L~ o(-1~ . However, I have changed my domicile to
(Strert and Numbcr)
and am and have bcen a bana fide resident of the State oi Florida since ~ day oi'
S'E~TCM Q ER 913 and 1/Ec de at R~ G Z X 3~.!'"a - T
(Street snd Number)
F T. p!~ R L E . St . Luc ie County, Florida,
(c~~y)
and this statement is to be taken as my declaration of citizenship, actual legal tesidence and domicile in the State
of Florida. '
(insert here any pertinent facts, such as sate of property or business, or relinquishment ot employment at former
domicile. remoral of tamily to ne~v domicile, purchase of home, etc.)
J?rTtR~v FRaM r~..1, G.ovc=/tNr,CF.T. HAv~ ~?ll6c~vTc-~ FA~•,~c r
pNa ~~R cH~JC=~ 1~~~~ ~ i paov~= /~,~~R~ rs ~~v ~caR~~~F •
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Entering children in school; .
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fILEO AtiU IIECpAO 0
' it• LUCIE COUMTY F~A. (u'
ROCEr ~QiTq~S Jt
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PFCOR
RYER~ i~p COUAT '
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' . Oc~ ~0 3 23 PH'73
' _ 265639
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I FURTHf:R CERTIFY that [ will register at my local address when the registration books reopen, and
~ compiy with all other requiremcn~s of a lcgal msident of this State.
~ I FURTHF.R CERTIFY that I have no intention to return to my former domicile, and I intend to remain in .
~ ~ T. ~~~RcL St. Lucie
, County,
~ Florida; permancntly. ~c~cr~ , c
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~s. c_.~~ L ~t AM M. %/L L n'rAN
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~ c = `y (Address)
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Swc~i~~tc~~~.s~lic;~~icforc mc this _1__ day ot
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~ _~^Lr_69~L~_~ A.D. 19~73~
~ ROGE~t ~~1~bt~fRAS, CLERK CIRCUIT COURT .
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~ Dc~puty Cler _ ~~,,~t~ ?A~,i ~
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(Ta 1x c~~•ru1rJ in Ju~~l~. :~s. ,~~~J i~n~•in.d (i1rJ ilh t'k~k Citcuil Coutt. artJ duplicatc Kilh Tax Asscssot)
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