HomeMy WebLinkAbout0162
O. R.
80J~
162
5
DeclGrotion of pomichTe lWtfJ~\li~frship
TO THE STATE AND COUNTY TAX ASSm~R.
-ST.. LUCIE COUNTY, FLORIDA:
. This ia my declaration of Domieiltl and Citilen6hip in th6 State of Florida th.s1t I em filing this day in
accordAnce, and in cOllfonnity with Chapter 222, Section 22~,17, F10rida Statutes,
I ffa8 formerly a lep.l resident of'______..__.BALD~n4_.J~.>.~G..-IS-LAmL------., __mti~__lQ_RK.__,.______..m
(City) , (~t..to)
and I raided at..~J5. ~__eJfer~_~!L~.~_r.~,e.~.._____..h.______.__n__ .____, How3ver, I have cha:lr-d my domicile
(Sb'eet uad Ntl':llber}
to and am and have been a bona tid~ resident of the Sta~ of Florida since_____, 23,rd.___n____n_______ day of
__________.~~~~IT_____..___.___, HL_ 6;!,. and ~ rtAide :l.t___l.QJ.mgr.~~g~h---fQr~..~~.-.r.uc~~---- ------.
(S~t and Number)
______~~~.~_~_!~.~J:~_________________., .__~_~-!____Lu ~!~______________._..__,_______ _____County, Florida,
{Cit'J)
. and this atatemeD.t is to be taken u my declaration of citiunBhip, a~tual legal residence and domicile in
the State of Florida.
(inNrt here IUlY pertinent facts. .uch as sal. of propertl or buaineu. or nhnqu:.hment of employment at
10nH!.' (\om~:lle. removal of iami17 to n.w domicile. J)urehaH. 01 home. .u.)
Entering one child in public school.
Phi1,Up C. lhlst
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928~J
, fllEO ANO RECORO,EO
IN~./t.U//BOOK .
1%1 l'\~R -3 ~l'\IO: 56
ROGER POITRAS, ClERK
Sl.lUC\[ cOlmlY. flORIOA
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I FURTHER CERTIFY that I will regia~r at my local addreu when the reaiatration boo~ reopen,
and comply with all other requirements of & legal resident of' t:Ua State.
I FURTHER CERTIFY that I have no intention to l1!turn to my former domicile, and I intend to remain
1_ Fo~t Pierce ___, St. Lucie
UL-- . _County, Florida,
(Clt7)
p&rmL"lAIltl1.
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,~Q...-t~~~'~P.W1bed before me thia.--1.~11q of
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K7 ~~~~.~ 6/21/6j_
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Harold L.
Rust
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(To be neMe4 ill dQUeato w ~r'.,tMl m.. with u.x ~...~ ~ IIaCl -,ue.te with 'hz A-.or)
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