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HomeMy WebLinkAbout1450 30.~823 ~ ' t Declaration of Domicile and Citizenship TO TNE STATE A\D (:UU\'I1' pRppERTY A~SESSOR ST~_ _I~~I~IE-- - - - - COUhi'~', Fl.ORIDA: 'I'his is n~y declaratiou of Duinici:e an.I Citizen~hip in the State of Florida that I am filing this day in aceord- ance, and in oonformity with Sec:tiun '_.:.,.•~.17, ~lorida Statutes. I was formerly a legal n~sident oE RQ~~~ter , New Yr~rk ( CicY ) ( State ) and I resided at . Ho~~~evcr, 1 have changed my domicile ( Strr~~t ai~d ~Iumber ) to and am and ha~•~ heen a tx~n:? fide resiclent of the State of Florid3 since ~th day of November _ _ lg. 74 and 1 reside at 6601 _Donlon Road ( Street and Number ) Fort Pierce, St. Lucie County, Florida, - - - - - ( City l - - - - and this statemrnt is to Le t:il:en as n?~~ ~1~•~ I,~ratiun c~t citiz~•~?ship, actual iebal residence and domicile in the State of Flurida. ( Insert herr :uiy pertinent facts, such ..~Ic of pm~x~riy or liusiness, or relinquishment oE employmeat at [omier domi,ile, renwval ot f:unily tu urw dum;c~le, purchasc uF home, etc.) f Retired as a school teacher and moved to Florida. Established residence here. ~~4Rp0E fd~~U~~Y /4i, l`:,L. ~~n°~A~ v`FAcu,T couRr ~l ; ~ M~ 18 I ao PN'15 , _ ~ 30~823 ~ ~ ~ { s `s ~ l Flif~TNER CER~'1~'~' that I~+•ill re~;iste~r at m~~ 1~~ca1 address when the registration books reopen, and 3 compl}' ~vit~~ all other rcquir~•~ncrsts riE a l~b:~l resi<lent of this State. ~ ~ I EURT1iER C:}?ItT1Fl' that I La~~e nc~ intentiun tu return to m}• [ormer domicile, and I u~teud to rein3in in ~ Fort Pierce - - st _ r.»,~; P , County, Florida, l ~~h' i •-1 , perrnanendy. ` ~ L ~ + ~ ~ ~ ~ ; _ Mary J n¢ Freema e~ T~ ( Address ) - Sworn to and subscr~l~ed before me t}us day of G601 DonlOn R07td _ Fort-Pierce, Florida 33450 _ - , A. D. 19.~_. : . _ . `~ti~~::~~~!:i~~?;~~~ ~q~ _ . ry Public State o orida at Isrge ' :r•'~~.?V y'~~i _ .!~s', p =;~;s,,1 ~ ~ My Commission erpires ~ - ~ ~ -,Z ~a: ;..t : ~5:`F- : - - ~ rma~:;Q ~ (To be e:ecvte+cl m dupLc~te and original filed~~Vit1; ~ ~ duplicate witb Tas Assworj t - ' • ~ ,.;c,k . . . : .:.••'.'S ` ' 4 - '''''''1r=,:i~«<,+~~``''``` e00N~~1 PACE1`~~~#--.-.< ' ~ 3 . . . . ~ . . . ~ ~ _ - _ . _ . . .