HomeMy WebLinkAbout1611_ -_ - ~ -
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Declarot~on of s . ~u~eCo°W"iTY. FlA ~' - P
TO THE STATE• AND COUNTY TAX ASSESSOR, ,
St.Lucis muNTY, aORID~ ~ ~ •
This is my dsclaratbn of I)ornidle and Citi>Dansltip in tM StaN of Florida that I am filing thb day in acoordana and
in conformity with Chapter 222, Section 22.17, Florida Statutes. `
legal resident of- ----=~~~_ ~~.8~ L4P~-----------• ----------------------
1 was formerly a ~,,.t .
(ttrr)
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and I resided at 1~~tu=i-- ~ ~~ .------------=------------. However,-1 have d~arped my i~omidle
to and am and have been a bona fide resident of the State of Fbrida since-_-~---~2>~------ POTt St. Ltlcis
61 ~ ~ -
~'~ ___-- -~_• 19____-. and I reside at ___ ~gp-$Any~A•-D e~~a--------
------Fort -Pierce- - -----~ ~~ - St. Lucie _----r~--~--- County Florida,
--- - cant -
and thi: statement is to be taken as my declaration of dtizendtip, actual legal residence•ar+~ domicile to tM State of Florida.
(Instil Iwn sMl p.rtMMM f.ct., wdi M wb ei prop.rb a 6rwYw~, or nlMquidrn~e~1 d .n~t0'W~ N ionmr dowidM. _
r«noval of frwllr w mw do~nidb. Pwchw of AorM..~cJ
Establishing residency
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1962 ~ ~0 As. a~
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1 FURTHER CERTIFY that I will register at my local address when the registration books reopen, and comply with all
other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
FD1Lt._pjHtCfl _ _--------------------. -------------------------SL.LnCie County, Florida,
-------- K++r) •
permanently.
BdMard w.
- -------- (/1ddrNSt
~••~ ~• 62
Sworn to and subscribed before me this___ 10~ _- fr.:r T•_day of, _________ January---_-______.___ _, 19_____._
1~ 4,.••~~'~ r .. ~, .
E~. ---------------------
R POIT CLERK CIRCUIT COURT ~ ; ~ ~- ; ::~ ~1 ~ ~''• . Notary Pubik
~~ ~~~, ~ ~'i f`~ ,-iMy Colrunistion expires-------------------------
BY --- --------------------• J~ ``
(T• ~. ms.N~ V ~.l..i/
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