HomeMy WebLinkAbout0106 268'7~ 3
Declaration of Domicile and ~itizenship ~
~I~U TNt: STATI: AhU ('OUN7'Y TAX ASSt'SSOR,
ST. I,UCIE _ ('pUN7'Y. FLORIDA:
"Il~is is my ~l~rlaration ot~ Domicilr and Citizcnship in thr Statc ot' Florida that 1 am filing this day in
arcurctanrr, and in cc~ntonnity with Scction ,,,.17, Florida Statutcs.
1 was I~~rm~rly a kgal r~sidrnt of __~~~?eeling ~N.Va. 260-Oj ,~nd 1 ~
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(City) (State)
? 1 4~a ~Y~i YtO~tAYI L!V RYIII P_
rr~i~lr~l at - - . ~iow~ver, i have ciiat~g~:c# lliy t~uiiii~il~ ZCT
1Strrrt and Numbrr)
and atn and h.~ve b~en a bona tide r~sident oi~ the Statc oi' Florida since day of
. 19_ 73_-• and i r~sidr at - 2-)$--~~'~!i-r~~o~d~--~V~~~ ~
lrret a~d Number)
_ _ _ Po~ t ~ t..L',~ci s - - - - _ _ , _ _ _ . -----~#~,u-ci~ County. Florida, :
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::nd this statcmcnt is to bc tak~n as m~~ dc~laration of ritirrnshi~,'actual legai residence and domicile in the State '
uf Florida. ~ ~
(I~t~rr. hrrc any prrunrm fartc, such st ulr uf pruprrty or bu~~nrss, ur rrlinyuishment ot rmpluyment at furmer , !
Jumicilr. remo~al uf famih• Io nrw dum~cdr. purch~sr uf homr. cl~.l `
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~~ew hor~e under coiistruction at: 218 S.~Y.Reynolds Avenue _
Port St.~ueie, Florida ;
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~ 268'7~3 °
fN.ED ~11f RECOit~E ?
• ~ ~OCER ?41T8AS~ Cj :
CLEitK C13CUIT COURT ~C
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R£COP.p YER~FtEO.~~~ ;
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; lion 19 12 49 PN'73
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~ I FURT}{f.K ('}-K~'IFY that I wiU register ~t im• loral addr~ss~when the registration books~eopen, and
r~mE~ly with aU olhrr requirtm~nts of a Ieral resident of this State. ~
~ 1 FURTHER ('t:RTIFY that I ha~~e no intention to return to my fornicr domicile, and t intend to remain in
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Port :;t.Lacie St.Lucie County,
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i Floricla, permanenily_ - _ ~c~~. ~ - • - - -
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~ _ _ ~ciward J. ~e an~~
~ 218 S.'~%.Re~r_n_olds r~vernaeL_________
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Port St.~,ucie, ~lorida
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~ Sworn to and subsrribed before me this `q.__, day o6
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~ ~ ~,or~ t' ~ ..~?~-~-Y_~'~ - - _ ~ _ . _ - -
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i= Q: Q~c~tate ot F7uriJa at Large ~ p ~
~ ; ? : _ Natx~r Pub~ic, State of f~aiCa st lar4~ ! :b~ .
~ ~'4S~Qn~ ~ ~s~_ MX Cos~ss+oo F.xpiru-MarclF&-~4Tb
: 1~l~ia hr ~•«K., E.. a c...+rr es,
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AR • Q~'"••''~~Ib bt r~rcuted in dupl~ratr anJ uriKinal filed with ('Irrk ('ircuit Cuurt, and dupli.ate with Tai Axseswr)
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