HomeMy WebLinkAbout1112i
Declaration of domicile a
, TO THE STATE AND COUNTY TAX AS3E330R,
S'I'. LIICIE COUNTY. FIARIDA:
Thin is my declaration of Domicile and Citizenship in the
accordance, and in conformity with Chapter 222,- Section 222.
I was formerly a legal resident of______BLRFA______ _____ _--_-_-_.
(City;
and I resided at-. _. Chi-gt-A~t___$~.xfle~,..~__.-_---- _ .._ _ .
LL (3t:eet end Nnmber)
Tll }ETA nl'M~ AAA ri74VP iN+i+ii is ~N~tu~ i~tiC i~iaiiii l~. ~`if ~~i$ .Q.i~tt.'
---------------------1t1IIe--------------------. 13.---g~ and I reside :;~-3
----------- ---------- ---- FortP~Qrce--------------------. --------------- --
(Clty) ~-
and this statement is to be taken as my declaration 'of citize
the State of Florida.
(Insert bare nay pertinent fasts. wcb ae sale o!~yropertyy or 1
forme: domicile. removal of family to new domicUe. purchase
Homestead
9
FILED b
Il`!~~"
195; ~~~
ROGERI
ST. LIfCIE
^ I FURTHER CERTIFY that I will register at my loca
and comply with all other requirements of a legal resident of
I FURTHER CERTIFY that I have no intention to recur
Fort Pierce St
in.~___-------------_________------------------.
(cry)
~+~'_
~--~---~
Re
Sworn to and subscribed before me this__~.g._.__day of
--- Janes-________---• A. D. I9 gl.
ate ~_ ac~.e~c.7~~
'- Notary Pnbiic 8tsta of ll7orida at Lrae -~
ll~j- Comndission ezpires~ Ten !b, 196
e7ro e. ezeeoted is annua.a aeM orl~iaai el.d with caert q
elsa+w poaJs G.. Pleat Ciq, Irla.