Loading...
HomeMy WebLinkAbout1360 ~ ~te~l~ratlon of ~omlcile ~nd ~~ti~e~s~ip i~~3(~g ~ ~ ~ . : j 't0 THE STAT~ AND COUNTY TAX ASSESSOR, • - ~ ~ ~ ~ SY. IUCI~ COUNTY~ FIORI~A: f 'i ~ This is my declaration of Domicile and Citi~enahip in the State of Fic~ida that I ~+m filing thia day ~ctordanee and ~ . ~ in conformity with Chapter 222, Se~ctlon ~2~.17~ Fiorida Statutes. ~ ~ H , j . Pik~ville Kentuck I was formarly a legal resident of ~ _ (ciy) _ (Sforol. . - and 1 resided at BOx 41b ' . However 1 hava chan$ed my domi~la : ~ ~ (Streat and Number) to arui am and have been a 6on~ fide resident of tha State of Florida since 1? day df . ~ . Nove.~ber 64 5200 S~ PedtxalHi hwA . , 19 , and I reside at g y : (Streef ared Number) ~ ' ~ fORT PIERCE, SAlNT LUClE 6AUNTY, FLOttiDA ~ . . • ~ and this statem,ent la to be taken as my deciaration of citizenship, attual legal rasidente and domtcite in the Stats ~f Ho~ldd. , - . . (Insert here any pre~tin~nt facts, such as sale of property or business, or reUnquishmant of O ~ ' . . j at former domicile, ~emovai of family to new domicilc, purchase of hame, ett.) _.~:y . l:1`'~ 7~ ~ ~ r V ~ _ _ , : .py+~,,,,.; k~_ . ~ V • ~ • M~T' . ~1.. : .t~ ~1~+~~.~ .,.~~.•aVQ. .,,~,.r ~.r i~ ~ , ~4,i,;~ j t. t y ~ ~ . -13~3~5'~~",,.. ~ . 8~tering soA ia lOth Grade • : ~~j~R QRO~~ ~ . . , . . lCi81~'~'~Z~,~~ . : . . . 800K :y . f : : . ~ ~ . ~ . l96k DEC -7 AM it: 2! ~ . ~ ~ ~ : . . . ~ SROGER P01TRA~. CLEIttC ~ ; . ~ . , . UCIE COUN~ , FtORIDi - ? . ! l~ ~ ~ ~ ~ . ' ~ . . . • ' - ~ . ` ~ . , - ~ '`r~~i W ~ , ~ i . . . . . . . . • ~ wr . . . . . . ' . - ~ . 3 i . . . . . . . - ; . . ~ J~ , ' ~ . ' i ~ , ~ 1 RJRTHER CHtTiFlf that I wil) o~mply with ell other roguiremenh" of e loqai resident of thi= StaM.~ ` 5 f j ~ . . ~ , i t j~ r ~ . ~ . ; . . . ; . I FURTHER CFRTIfY that I have no i~ientian to return ta my former. domi~ila, and ! intend to ~emain tn FORT . ~ PlERC~, SAINT LUCIE COUNTY FLORIDA rmanentt . . i ~ , , I~ Y / n . j ' ~ /I ~ . . - - . - . ' . ~ 7 7 . . . . . ~ ~ ' . ~ ~'1~ , (Na~ma) . . ~ ~ ~ ~ • ~ . • . . ~ ~ ~ _ , : . . ~Q, . ~ ~ ~ • ~ Geor~e Hatfield, Sr~ . ~ yf . ~d ) . . , A~ ras } i . :ti~'~~:,~~ - . ` " ~ `Ao - , . ~ ~ ' ?th . December ~ 64 hr` t an~ substrib~d befor~ mo tfits day of ' 19 ~ . - r . . . . ~ ~ ~ ' ; - . . . ~ ; ' Roc~t wrr~?s . ~ ~ ~ C!R !T COURT . ' . Pfotary Fa~bik ; ~ . ~ . , ~ . ~ gY _ D.C. My Cortunission expiros , : ~ ; ~ - (To b~ ~x~evhd i» dupl~ a~ orf~lnsl Hl~d whh Ct~rk Ci~aril C~wG aad drpiirs~ wiok Tax Ilt~o~a _ . ~ o. '~45 ~ac~'~.CQ . . - . ~ ~ 8~,.~ - . . . . . ' . . - _ ~,S ~-er . ~.~es.4 - ja ~ j^