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Declaration of Domici~~' ~~~~ ~~~i~~~hi~
TO THE STATE AND'-COUNTY TAX ASSF~30R,
sr. LIIC ~ _ CovNTY, FLORIDA
This is any declaration of Domidle and Citizenship in the State of Florida that I am fllin~ this day in
accordance, and in conformity with Chapter 222, Section 222.1?, Florida Statutes.
peixarro ~,TOricovl~r _-- am>~aza________--
I was _'_:merly a legal resident oi-----------------1----------------- -------------------- ------ -
_ caa~ cstt.~
~"'` "'~"^ ... HOA6V8l, 1 hwVP Phf-TOPf1 T11V f10TlI1Clle
and I resided at ~ - . - ' "'
(Stswt gad Nnmber)
to and am +-•a3 bare bin a bona fide resident of the State of Florida since -- --_ -- sth_.--- - -------.day of
Deo e4bsr b0 163 Estia Lane, Port 3t . Luci i ~-
----____, 19_=_, and I reside at-_____---------------------
------------------------------ (Street ead Number)
___-__ ~Qrt pi~4~- _ - - ---------._ St .Lucie _County, Florida,
' (Ctb)
and this statement is to be taken as my declaration of citizenship. actual lesal residence and domicile in
the State of Florida.
former domietl% re ~ial ~ taas~7 to new domkile. parebsM o~ 1oat~,oite~~nishmeat as ~ylo~twat at
9237
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F~~__~ ~ '~!'C F.~CC'.CEn
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~6i FEB i ~ lll'I io. 52
ROGER n(1tTP~,~, ~~~"-~ ~"~f~
V . ~ ~ f~
and oomplyall pother requirementsts of a legal ir+ealdent thiadreaa~when the registration books reopen,
I FURTHER CERTIFY that I have no intention to setura to mJ- former domicile, and I intend to remain
~ fort pisroe 8t. ie
-^_._., _County, Florida,
caa~
pe~aaanently.
cx.~.~ --------
?red~ L. loafer
Swarm to and ~p.r.yd- ~tK,is::-~=-~ ~
l brui r~ .• ....,, D.18..~...
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Iir Cc+®aoiwfan
(1'o be ~eotM"~Ij
fbd will Aed< Ck~eek Chef, as~d wki Ta; Aseswoe)