HomeMy WebLinkAbout1616' of Donl~cYi`t's.ansi _ i ~ze~'n~~ahip -
Deciarot~on
St. IUCiE COUKt~Y ilA• ~-
TO THE STATE ANO COUNTY TAX ASSESSOR. ,' v
3L. Luc~i _couNTY. HORIDA:
. This is my dedaratipn of Domidle and Citizenship in the State of i'lorida`that 1 am fiiirp this day in accordanoa and -
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~ _ _
I was formerly a legal resident of-------Fairbaflki-- ~-----------------• _.Alaa-----------
---------____-- ,_-. However, 1 haw lunged my domkile
and i resided at ______l~-F ~ ~ ~ drh~ ~
to and am and have been a bona fide resident of the State of Florida sins---_----- ~----=-------------- d+Y of
-----~~-~rn4r_ tt~d-------
-----F~~I'1LaiT----------------------------• 19__~, and I reside at p,r..+.n+ wu~b..)
-----Fort-.Pie~ca--------------- ------------
taMt
__SL.-I.liCia----------------- Counry~ Florida,
and this statement is to be taken as my dedaration of dtizenship, actual Is~ai residence and domidleln the State of Florida.
p~ 1»n any p.rNn~d t.~. wd+ « wM of prop.rty or tw~Mwb or nYnquidrwM d w~1or~ a fawnr domkW.
n,novl of f.niYy w ~wwr do~idM. pvrclw. of heww, MeJ
Applying for hasestead and also for xidot+ benefit
ltrl'760
Ala is
1961 •~'~ ~~ p5. C~
ROGER p~tlNt'~• F1.0R~a1-Q,• ~"~
st, ~tiC1E C®
... ~ ;..
•~-
"~••_
I FURTHER CERTIFY that 1 will register at my local address when the registration books reopen, end comply with all
other requirements o'F a Isgai resident of this State.
I FURTHER CERTIFY that I haw no ir~tentkan to retwn to my former domkik, end 1 intend to remain in
~~~ For. t.. Pierce St. Lucie County Florida
Lw~.~--~---- -- --.~ -------------
~~~.~)~.•,1 • •
• ~ ~ .. ~ (AddrM~
.~E t: C~~ •••.:, ~ ~, rrte this------10 --- -----~Y ~ :!II9~W'3~'---- --• 19_ ~~.
Sworn to and wbsuibed before --------- ~--'--
- ----Snt~_PaiL~>e~~.K ul~aT~YCOi-fCt ~ ---r~___~~ ~~ ------------------
r I~,rrd.~ ---- ~.C. My tornrrtiaion expires_ '
gY -- - - -- ---------- --- ---------------- -------
(te M MMwM~~ r ~~ .ri alew~! If~/ wail ClnL C6wN ~+wb ~ ~~~ ree Tsr Aw.wd
s~oo. n. ~~isa~