HomeMy WebLinkAbout1740 Declarat~on of Domicile and Citizenship ;
~
~ 295096 `
TO THE STATE AND COUNTY TAX ASSESSOR, ~
. ,
r.»~~ A COUNTY, FL.ORiDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in
accordance, and in conformity with Section 222-.17, Florida Statutes. -
1 was formerly a legal resident of Joh*~sQn Kansas and I
~Ly~y~ (State)
resided at ~no street eddressZ . However, 1 have changed~ my domicile to ;
(Street and Number) ~ ~
and am and have been a bona fide resident of the State of Florida since ~ 2nd day of `
Auqust , 19 74 and I teside at ~t 23. Block 2823, 402 .
(Street aed Numbet)
~ T~,~{ ~ ~ St. Lucie County, Florida,
.
~ (c;~r) - .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in t6e State
of Florida,
pnsert hue any pertinent fxts, sucA as s+ile of propertr or busineis• or reupquishment ot emploYmeat st former
domic~e, removal ot fsmiir to naw domic~7e, Purchase of home. etcJ
I am on active duty in the U. S. Marine Oorps. I intend to live at -
the location.cited above upon my re974ement from that Service. I
t this ro rty on August 2, 1 ~
bough p Pe ,
s
29SQ96 .
~ ~~~ac~`".'~. ~ -
~ . . R0~ R PQI~
! 6lERK ~IR~E ~ '
~ Rf CORd YER~~1~Q
~ ~ ~ ~1 _
1 FURTHER CERTlFY that I will register at my local address when the registration boolcs reopen, and
comply with all other requirements of a legal resident of this State. = . '
,,,'`~~~tIt1~11~y~~~~~ ~f.~ t
I FURTHER CERTIFY that I have no intention to return to my former domicile, and Iai~Y:tia4d~y~n~n . ;
;
Port St. Lucie .•Y:• " ; :
Fiorida permanently. ccnr~ - _ _ _ .>h-' , Gs. -
, ~ . ~ ~ ~e
- ;
:.~,r
L ter Jr 1 -
.:Y,
(Name) 'J • '
.y ~ ~
y ' . ! ti ' r..
~
. ~j i
~993 Jamestown Ct.. 1~ t~,e': Va. t
State of Yirginia . (~rrent mai 1 in~°~~~ ?
CouxYty o~ Arlington: SS .
Sworn to and subscribed before me this ?.~h--- day of ~
~
November A. D. 19 ~4 3~
.
JwdY K. Bnicellt . _
Notuy PuWic ~ ~
My Commission expires 2 Nov 1976 ~
(To be executed in duplicate and original fded with Clert Circuit Couct, and duplicate with Tsx Asmsot) "~a
~
~3 -~i738 : . .
_ . ~ ~ :-~.~.e.,;,~ ~
~u. ~
_ _ ~
-