HomeMy WebLinkAbout2345Declaration of Domicile and Citizenshi~oK 4 374
TO THE STATE AND COUNTY TA8 ASSB,SSOR. ST, IUCIE COUNTY, FLA.
St _ Lun is COUNTY. FIABIDA:
This is my declaration o! Domicile and Citlsenahip in the State of Florida that I am Slim this day in
accordance, sad in oonioranity with Chapter 222, Section 222.17. Florida Statutes.
resident of ~L~~~-a ---•
tlaeke
I was loetmerly a >~l ------- - -----------
ccxa~ teat.)
and I resided stRn4~09~.~~e_-Dti~n_----------..~---------------------- --_--. however, I have cheesed my domicile
(8tewt asd Nnmb~r)
to and sm and have been a bona &le resident o! the State of Florida since-----------filet-____ ___________dsy -o!
--~agt,.~-- --------------. 19__M, and I reside at.___~..~_.BO~~'S-H._-~_--------_--------------
(8trest and Nnssbar)
lrt . Pi era a SL .Lucie ______~~____ ___~q,~ Florida,
ctx~,~
and this statement is to be taken as tqy declaration o! citizenship, actual 1e2s1 residence and domicile in
the State o! Florida.
(I~wrt dra an7 vertin~nt facts. saeh ss sa{a_ ~,pt'oPu'm~ehs~e at bom~.aite~nisLa~nt ad amDlo~m~at at
orma domkile. removal of tamib to new aomu~, p
,- -
. -..,.
g~5A6
FI~EL .A';D RECO"!JED
,,1
1961 FEa Zl ~ ~ 19
ROG'~R ~OITP,r1S. ~1~~'
(- - ~.~
y .
I FURTHER CERTIFY that I will re~4ter st ml- ba-1 address when the rseistration bootie reopen,
and comply with all other requireznenta o! a le~a1 resident of this State.
I FURTHER CERTIFY that I have no intention to r+rturn to ao' former domidle. and I intend to remain
~ Pt .Piero• ~ fit. Luoi• Conn~s, ,
,z.
r:'~, ~ * ~~`~"'~!~•,,.,, r~~~~ : Rt. S Hos ~~'°~.~e•Pie~ae. Ala.
belat+s ms
- ~ ~3L1~1c Q~OOI? oQVS?
~...
•tue~`'°
- •.~,P y -^~.
--.- (71z tie ~N/ !a ir•iliste ~ setdlsal ~~ wlflr Q~e1t Qlemit ONeR aei Este wltlt 11~a~ •sewe~)
af.w• esaNs Ow. Tlsat db. e~fe.