HomeMy WebLinkAbout0738- -- ST. LUCIE COUNTY, FLA.
Declorotion of Domicile ond• Citizenship
TO THE STATE AND COUNTY TA% ASSE.gSOIt,
3T. LIICIE COUNTY P'I~OR,IDA:
Thin is my declaration of Domicile and Citisenahip in the State of Florida that I am filing this day in
accordance, and in conformity with Chapter 222, Section 222.1?, Florida Statutes.
I was formerly a legal resident of______-BII~3HAl~1'QN____________________________________.___-_-. -------:_--~_lrX4RK_._-___--
(City) (state) -----
4nd T re4ided at P..~.' I~i,A Htrt~~t. - _.-_--._ However, I have changed my domicile
(3trest sad Number)
to and am and Piave been a bona fide resident of the State of Florida since 18t _ day of
Se LemDer -_-. 19~u-_-, and I reside ut _______I31__4lJ.QQLl~_t%S?1iL'Tea_t'_Qt~e____~__}4_aL1lQ]H
- ---- -p----------------------- ------- --
--_ (street and Number)
Fort Pierce 3L.Lucie __ __ __ ___ ___ ___ County, Florida,
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ccity) '
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
(i',nsert here any pertinent iscts, such ss sale of Dropertyy or business. or relinquishment of employmeat at
former domicUe, nmo~al of family to new domicile, pnrchaaa o! home. ate.)
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Gn ~n nUn RFrnRnrn
I~: .!~~J ~ 7 Pi ~• ny
' :';~ ::R ROITRAS, CLrr•~
~,. L'JCIE COUNTY, FIG.. h
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I FliRTHER CERTIFY that I will register at my local address when the registration hooka reopen,
:,3 .=.._r.:: 1~ tcia~ ^11 ..4!;np y:....I;rnr!-.nr44 Rf fl lp~*!!~ tP}ii[iPnL nT LIIiB ~LATR.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
Fort Pierce St.Lucie _ __________ __County, Florida,
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ln------- - ---- -- -- - - - -- - ------ ---- ---- ---- --- --------. --------------------- - - -
- ------ --------- -
_ (City) ~~ 1~l~
permanently. 1 ~ ~ ~~ _ ~%1~- - - ~--------------~ - --- -
- - ---------------------------
------- -- ------ -
(Name)
Clayton 10. Aiaea
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(Address )
Sworn to and subscribed before me this-_~7_t~-day of
.....,
..
Januar _ ' -
•i F •----- - D. 1951---•
-- ---- ----- - arr i~f~ :states -- `I:rs. Z-
My Commission eip~s ~ -. l -_-~Lss~ ----------
~;.
(To be e:stated'iri•'dip~lpt~,e-at-~'oriRbtal filed with Cletk Cirenit Conrt, and duplicate with Ta: Assessor)
ftnw~ Buonlr l'o.. Pl.nt C1tR. ~lif."' ~•