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HomeMy WebLinkAbout1968 Declaration of Domiciie and C~tiz~nship TO THI: STATL• AND COUn'i'Y TAX ASSL'SSOR, S t. Luc ie 265~?7 - - COUNTY. 1~ LORIUA: 71~is is my drelaration of Uamicil~ and Citirrn.hip in thr Stat~~ of I~lorida ihat 1 am tiling this day in accordancc, aizd in conformity with Srction ~?'.17, Florida Statutrs. ~ 1 was fonnerly a Icgal nsidcnt of~~ifL~ ~~:LG~i~~l:~" - , ~ - ~nd ! (citr) (stace) resided at ~~~Y/-/f! C a~- T~Rne~- . However, 1 have changed my domicile to ~ (Street a~d Number) and am and have bcen a bon:~ fidc resiclent of the State of Florida since ~ day of now ~ pL , 19 70 , and I/Eeside at ~~s/" ~ . (Street and Number) . S t. Luc ie County, Florida, (c~~r) and this statement is to be taken as my declaration of citizenship, actual legai residence and domicile in the State of Florida. ~ (Insert here any pertin~nt facts, such as sale ot pro{xrty or businrss, or relinquithment ot employment at former domic~le. remo~al of tamily to ne~v dumicilr, purchase of home, rtc.) • Entering children in school:~ ~ filFO ANfl RfCOR0E0 ~ ST. LUWf GOUNTY FU. ROCEa ?O+T1t~S CIER!( Ci~ G~iT COlfR7 ~ REr,pRC YEe,t~c~~~~ Oci t1 9 s2 AM'13 - 26588'~ I I ~ I FURTHER CERTIFY that I will rcgister at my local address when the registration books reopen, and comply with all other requirements of a leaal resident of this State. I FURTHER RTIF h:it I l~ave no intention to return to my former domicile, and I intend to remain in ~ ~ ~ ey-t~ ~ St. Lucie , County, Florida, permanently. (c''''~ U ~ ~ C'^ v~~%~-' r v,i ' = (Name) •c~~ . . - r: _ } = R3:. ~ - ~~i- G~~~~ _ - • ~ : ~ (AdJrcss) ;:i.:: , _ . "I~ . ; ~ - .~S~~dorti to at~d.Su~n~bed bcfc~rc mc thi. --f clay of ~'%~~'1~~:-~.-~ ~DC A.D. t9__ 73 . - ROG~k POITRAS, CLERK CIRCUIT COURT . - - ~ K 219 ~1967 - • 800K Y f B Deputy Cle (To Ix rxrculyd in dupfi.alc :~nJ ~~u~i~~ J J~.~th t'Ir~1. ('~rc~nt ('uuil. auJ Jupt~..~tr ~vith Tr~ A~x•suN) . s;:; ~ ~ . - - - ~ , ~ wr~- _ , _ . . , ~-s?~v:.~.,~~r:,~'