HomeMy WebLinkAbout0783- ~oK 2 174
SII. IUCIE ~ UMTY~ F A. ,
Declaration of Dom~ci~e an~ Ci~zenship
TO THE STATE AND COUNTY TAX ASSE.g.SOR,
ST. LIICIE COUNTX. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in
accordance. and in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of-__-- pEEECHOBEE__________________ -----------~-~~------------
--------------------------. - - (State)
(cia)
A„~ ~ .~..:d~ a# P.O. BoZ 149 - ~_----- ----------__- __.- _ - However, I have cll:-nged my domicile
(3treet and Number) -
to and am and have been a bona Sde resident of the State of Florida since _ _- -.. .._---- day of
w
Jude __ lg_ ~_, and I reside at-------4GU9__AVSnueL --------------- --------- --- ----- --------
(8treet and Number)
l~or t Pi src a 3t .Lucie _ _ _County, Florida.
- ---------------------------------- -------------------------
(c,~tq)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State of Florida.
f Insert bare any pertinent iactac, such is sale a1 yzopertq or b~uain~eas•• o~relin4uiahment of emplogmeat at
torme: domicile. removal 01 family to new domicile. p
red i ivied ia0k~eohobee for e~out five pearl!. Hea neverreRistered to vote.
!Loved to Jackaon,Keatiucl~ for oae pear betwaeaths i,ilae i.l~oy i~6u iu
Okeechobee and time iivin~ ill Foit Pierve.
81.582 :
..
,,,
,,, .
FIB E~ AN
D FtEC;uNUtu .: `,,~.:-. :, :yG; .
_
~..-.
_ v
~ :
~1
Y .
.. +- '-
, .
`
Si
LU
CIE COUNTY
FLOkt;;A ~~ ~''~~';i~~ ~
~
~•~~~
.
,
e
I FURTHER CERTIFY that I will register at my local address when the registration hooka reopen,
nr~ enmply with all other requirements of a IeAal resident of this State.
I FUF-THER CERTIFY that I have no intention to return to my former domicile, and I intend to remain
Fort Pi era s 8t . Lnc are ___~nty, Florida,
((~a) _ _~
permanently. ~ ,
~ l ,----~~--------------
aeor~C. Parrett ~r.
T tAddtw.) -------------------------
1.,~..~~•.r
Sworn to end- a~i~~me thia__~Sth ~y ~
,~ .... , •;'j,., ,.
Ja ~ ~' ~' ~. D. 19 Y
~4
at Lr~
~,-~~. .tea r ~•rj•.~c-
>le~y Cori. ~ +:~• 6jE1/63
~ ct . `~`'
(1b be eseeutld 'in -au~ife~b and a:igiaal sbd wkL Cies>< (Xneoit Court. sad dsDlieate with Tau Awes)
aeww Mselr Oe.. Pltat Clt1. irla.