HomeMy WebLinkAbout1661D~ciorotion o~ i ~~11n ~irizen:hi
TOT I° STA ANO 4*JUNTY TAX ASSESSOR,
-~-~-~~ COUNTY, aoRIDA:
This is my declaration of Domidle and Citlzar-ship in the State of Florida that I am filirp this day in aooordanoc and
to conformity with Chapter 222, Section 222.17, F1orWa Statutes. .
1 was formerly a legal resident of________-- --~--------~-------------- --. -
----------------------
liar) Ara.J .
end 1 resided at ~~ ~ ~ ---------------. However, 1 have dtiangsd my domicile
- ----~~ and -~h,mb.rf -----------
band am and have n a bona fide resident of the State of Florida since_________ /~ ~___ _ ~y~
~.~ .
------------- ------ ------------------• 19i~ _, and 1 reside at _ I ~ y -------- ----- ~ ---
Rn'.a and Nuw~b.r)
~/~!G_ _'~~'~='~---------------------- -~~~ ~~tc~!'t'~ ------- Cainty, Florids,
lacy) ---
and this statement is b be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(In«rf Iwa any partMnM fatM, each « wla of pop.rty a t~wiiw«„ a ralNqubtrnaM of Mnploym.nt a tonnaT domigM,
ranaval vt fanny to nawr domidla. purcM« of hen[, Mot
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FaED AND ~ECORDED
M~BOOK
1961 JAN I I PM I: 39
ROGER POITRAS, CIERK
ST. lUCIE COUYTT, FLORIDA
c~~'
I 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 FURT ER CERTIFY that I have no intention to return b my former domicile, nd I intend to remain in
e-t~i ~~4C~i ~ _~'u-~.-1._________ County, Florida,
(City) -
permanently.
- ,~ _
Sworn to subscribed a me this- __~~ _ r '~`, of. ~ __- __-____-- ___--- ___--
~ct/ ~ ..•" . • ...
-l•~ •~ ,
- ..
:'!s i
- - -- - -- - - -- -- ------ - --- -------- - / ~) 4-- --- --- ----- -- --------------------- ---
R ITRAS, CLE CIRCUIT COURT % > ~~'. ~ r r `•- .. ~ •' ~ Notary Public
By "•AC~J ~~•'~ ~~-'Commisiion expires--------------------____--
(r. i..:asM.~ t^ i~liCw ..~ «iW.l ~ .iY cl[a< CM[.i Gwr, «+ J~Caa .rYh Ta: w«a««f