HomeMy WebLinkAbout085490~~ 2 2A6
Deciar~tion of ~i~~~~~itizenship
TO THE STATE AND COUNTY TAX ASSB.9SOR,
3a i nt Lua i e COUNTY, FLORIDA
This is my declaration o! Domicile and Citlsensbip in the State of Florida that I am filing this day in
accordance, and in conformity with Chapter 222, Section 222.17, Florida Statutes. -
• ---------. ------- Ya a e-+ -----------------
I was formerly a -legal resident of_._-----------~?~!s- - ------------------------------ (8ti~a)
~cla)
and I resided a.'..- Gir.auit Aves___________•------------ --- -- - --- __- However, i have changed mY domicile
(bpi ~..: tiv~~:i _ day of
to and am and have been a bona fide resident of the State of Florida since .- - ~~ ' -- -
i nne I~....t w~ At vA _ _
________-_-_____Q___e--ber_________________^_ , 19___-$- and I realde at-_________------------- --- (Street and' Numt+er)
-------------- F't . Pura e ---------- -=-------- -. --_---------- ---mint _L~tcis___--------- -----~nnty, 1:'-iorida,
_" (cis) ---
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in
the State o! Florida. -
former misU~remo~al of lamilT to ew dodomicilo~p i~+eha~o ay ~o~rolin4uishmont of employment at
establishing residence here
91.~~
F1LE0 AND REC RDEO
. ig00K
I1J _
IZGGER POITRAS, Clary
S-, IUCIE COUNt'f. FL(l' ~~ '~
...:;:..
- -,.~U l .
:, ; . .
. ~ ..
:'•
I FURTHER CERTIFY that I will register at my Local address when the registration hooka reopen,
and camplY with all other requirements o! a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, sad I intend to remain
in Fort ~Pierae - ~ St Lu i __~-Connty, Florida,
- (cab) ~~~~~ --- -
pernsaitemtl~• _ _._
(Nas*e)
- Eta B. ~tossirs
Swos7- to and i»b.cribed b~fae+a me this ~9 dy a[
Jdnwrl , A. D. i>rl d~
a'-~-+~
PNlie 8bM K lkeYa atLtre
11~;/ (~OtnII'iIM~ N~pi>~ t II ll~j ~.4 ~
-.r£ ~-
~: `~~. , 3dbr,~.,, ,;
~~~~~tlp ~ 4,y ~ :a • .
+,o`G. . ' J .,~.~~ . .
,'--1 ~
1• .~. . ~ ~ 'i:
.. ~#~O
(7b iw d ~Nkab .a+ aiglest fU.+ .wit G.e~t ClesdteDwit: w~ +w vita ~ Aw..oe)
a.,ww s.sar Cw. >lYat aa. ri.
a