HomeMy WebLinkAbout03266G(~K 4~ PACE~.~~~~
I~FClarat:an of Domicile and Gitizersg~iip
ST LUCIE CCL~NTY. FLA.
~r'.____~_.._ _ _ ._
TO TIIE S;ATL' AND COUNTY TAY ASS~~SOR,
3T. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance
and in conformity with Chapter 222, Section `172.17, Florida Stntutes.
Lon~3 Island New York
Z was formerly a legal resident of -- -•
[City] State
anct I resided at-~~~r~ 2'~rd StrA~t: Aatnri~L~I. However, I have changed my domicile
[Street and Number)
to and am and ha~•e been a bona fide resident of the State of Florida since ------ 12th day of
c~i~ I'C
19-_,~d I reside at ~90~ AVe. P
[Street and N-unberJ
E`ORT PIERCE, SAINT LUCIE GCUNTY, FLORIDA,
and this statement is to be taken a: my d=claration of citizenship, actual legal residence and domicile ui the State of Florida.
[Insert here any pertinent facts, such as s31e'of property or business, or relinquishment of employment
at former domicile, remo~•al of family to new domicile. purchase of home, etc•]
~.stublishin~ residencY.~
l i.01~'7
.. FILED AND RE oDr~DB00K
..
. - ; , ~-~ ~ 1961. NO`J -6 AM 10:59
.: '' ROGER P ~~ RY FLORROA
..:... . ~ ST. LUCIE C e~,~
~~,
I FURTHER CERTIFY that I will register at my local address wl.en the registration b~oks reopen, and comply
vrith all other requirements of a legal resident of this Stat4.
I FURTHER Cr:RTIr y that I have no intention to return to my former domicile, and I intend to remain in
FORT PIERCE, SAINT ~LICIE COUNTY, FLCRIDA, permanently. '~~ o
JUHN ~oersch
;Address)
Sk•orn to and subscribed before me this Bth 3 of ..- ~pVv:Ab~°3' 19_ $2
' ~ '~
ROCE POITRAS ' '` =` 4• ~ ~ ~-----~ - _- --
ERh CIR_C_/UyI/T/f'~OURT -.. ~ -, Notary Public
3 4_t~~<.~~ ~ 7GL e-~ _ ' jjL,~ ~~ ` 3.. ?dY` COrnmi~sion expires
c' ' '~~~
[To be executed In duplicate and orifCinal filets cvltlr .Clet'k Gtlt~uft Court, and duplfcata wlfh 'hx Asseaanr;