HomeMy WebLinkAbout1536•-•` - i ..
Declorotio 10 ~~ , ~ , ~tizsnship
TO THE STATE AND COUNTY TAX ASSESSOR.
4 T.~~{ w COUNTY. FLORIDA:
This is my declaration of Domidle and CMizenship to the State of Florida that 1 am filing this day in accordance and
in conformity with Chapter 222, Ssctior- 222.17, Florida Statutes. '
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1 was formerly a legal resident of_____------ --~ SaCt38~ tt~
• ~•Ldpsfl,4llla_agtil'~Ll~--------------. However, 1 haw durged my domkile
and 1 resided at ____--1-.~-~-- ~ ~ ~~t
to and am and haw been a bona fide resident of tM State of Florida sinoe___________~rb.__~__--
_ 19_~_, and I reside at __~~4 $:Ald_t'!a $t>:'eets______
' ________3t.Lucie ----------- ~nM• Florida,
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and this statement is to be taken as my declaration of dtizenship, actual ls~al residence and domicile in the State of Florida.
p~wrt twrw +nr p~rtL~ lath, suds w alp of ~ap«ty w hwiiw~M, a nYnquNtnw~nf of ~PbY~'M n forwwrr do~wtcfM.
ra.noval of fr+Nly a waw daeldMi. twrchw of Aoiw•, a1tJ
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1961,~N -9 ~ Ip: ~0
ROGER Re BRAS CLERK
ST. IgCIE ~O~NTy; FIORI
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pj~~ranS ..'1 •`. .
I FURTHER CERTIFY tha! I will register at my local address when the ragistratwn books reopen, and comply with all
other requiremenri of a legal resident of this State.
I FURTHER CERTIFY that I haw no intention to return b my former domkile, and 1 intend to remain in
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permanently.
a
St..I.ucis-------------- ~-ntY• f~orida,
----------------------
ski .- snke~
~ ~ ~ ~ svibed before me thk___-_-- 9ltL -----d+y of
s~ . •. .
e .~~~~~~Q~r~ RASA CIERK CIRCUIT COURT
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$~. Pinbo
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---------Notary Publk
D C. ftAy CornrnMtlon expires --------------------------
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