HomeMy WebLinkAbout1969 . . _ . . _ _ . -
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De~larati~?E~ ot C~omicil~ ~fld Citizenship ) 1
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TO THE STATE AND COUN7Y TAX ASSESSOR, ~ ;
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Sl . lllClE CQ~
~NTY, F! ng~nA:
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in canformily with Chapter 222, Section 222,17, Florida Statutes.
Live Oak F~orida ~
I ~vas formerly a ~egal resident of _ , - ~
(City) (State)
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anc3 I resided at Rt 5_~4?X _97~ . Wowever I have changed my domiGile ~
(Street and f~lum6er) ;
to and am and have been a bona fide resident of the State of Florida since _ day of ~
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_______.Novembe r_ _ _ , t 9__~ 5, and I reside af . _ _33b__ j~oh~sa,ra ~ t *-A o + '
(Street and Number) ^
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA `
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and this ~tatement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(fnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Applying for hornestead
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~ FILED AND RECORDED . ~
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. J~ - ~6 FEB 1~~'~~,t) }
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• 1' ~i ;~t~S. CL ~
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~ ~ ' ` LUCIE COUNTY
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I~C i;~'.~. ST. FLORlDA ~
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; 1 FURTHER CERTIFY that I will comply with all other req~irements of a legal resident of this State. ~
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT ~
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PIERC~,•;~7~fN~;4~1~1E.~CQUNTY, FLORIDA, permanently.
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~ . 4; ~ ~ . - r,; y _ (Name)
; Ralph J Platt
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Sworn to and subscribed before me this 10 day of - February ~y 66 ,
ROGER POITRAS
RK CIRCUiT COURT Notary Public
gy D.C. My Commission expires
(Te be executed in duplicate and original filed with Clerk Circuit Court, and dupliute with Tax Assessor.)
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