HomeMy WebLinkAbout0593~,. R• ~ ry
90:k ~~ FACES~~
_ LZeciaration b~; ~3ot~ci~~,~d: Caiti.zent:4ip
TO T'IiE STATE AND COUNTY TA7{ ASSESSOR, `
3T. LUCIE COUNTY, Fi.ORIDA:
This is my declaration of Domiclle and Citizenship in the State of Floiida that I am filing this day in accordance
and in conformity with Chapter 222, Section 222.17, Florida Statutes.
9T~2I+TFGRD, ~ C(~NAi.
I was formerly a legal resident of_ - -
[Clty) State
255 Rockland Ave.
and I rnslded at - -. However, I have changed my domicile
[Street end Number) 11th
to and err. and Nave been a bona ilde resident of the State of Florida since day of
November 82 1801 iTd 3ileia~icQ Dr.
19- _, and I reside at _ __
[Street and Numberl
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA,
and this statement is to be taken as my declaration of citizenship, actual legal residence an9 domicile in the State of Florida.
[Insect here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of 'amily to new domicile purchase cf ho-ne, etc•l
ENTFRIN('t ONE (1) CHILD IN PUBLIC SCFi00L
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(6 yra)
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F!~ED AND RECORDED
(nie'al rd BOOK
1962 (~OV 13 QM 8: 23
ROGER POITRAS, CLERK °
ST. LUCIE COUNTY, FlORIOA~'
I FURTHER CERTIFY tha: I will register at my local address when the registration b~oks reopen, and comply
with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I havt ,:o intention to return to my former domicile, and I intend to remain in
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
• ~ ,~ ! (~ [Name]
,_ ~ :'ti_~,, ,;.~ ~, a• - Michael ~'. Vrabel
a t ~-~-~' °~•~~ [Address)
'-_~•~.: ~. ~ ~ : ~. u ~ 13th November 62
" •.~rorn to ah~d 8u~scribed before me this 9sy of - 19
`'~ >3 IRCUIT URT Notary Public
c
3y `yw D.C. Afy Commission expires-_
llAVID ~I. Vr~SBEL
,,...
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(To be exec~fed In dapllr~te and origln:.l file3 wig Clerk Circuit Court, and duplicate with Tax Assessor]