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HomeMy WebLinkAbout0875Der~aa~tir,rt of ~un~:cile ~~ ~i~ens~up _ BOR: ~ ~o >~cE 19~ TO THE STATE :1ND COUNTX TAX A~E.43QR, ,..._ . 3T. LuCIE Cot,*N~rY, FL~'RII)A: ~ ST, lUC1E CHUM i Y,_ FLAk• - Thu is niy declaration of Doarlcils ~d Citizenship !.n the State of Florida that I am filing this day !n accordance anrd in conformity wiW Chapter ;tZ2, Section 2gZ.17, Flaridt Statutes. I wa. formerly a legal resident oi-.-~~.~'~~---(~~] ~~~* State and I resided at-----~ ~ t - -- However, I have changed ,ny domicile • (Street sad Numbd; ] to ana am ana have been a bow fid. resldtnt of the state of Florida sines ~_ 14th ~ day of November 8?. 303 ~. 22nd street , 19., _, and I reside at [Street. and Number] FORT PIERCE, SAINT ~,LUCIE COUNTY, FLORIDA, and this statement Is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. a (Insert here~ny pertinent facts, such as sale of property or business, or relinquishment of employment at former domicile, removal of family to new domicile. purchase of home, etc•] Tstablishing residency 1.04.83 ~~ F ~ AHQ RECORQEO 1300K 1961 NOV i 9 AM -0: ~ - SR~GtiC E POUNT~S'IORIDA N'F . ,. ~: . ,_ . _. ~e,1. ,~ • ~;~~~' ,' . I FURTHER CERTIFY that I will register st my lo^_al address ~~hen the registration books reopen, and comply with all other requirements of a legal resident of this State. ~,.•I ~'t!R'FH~t CEFi.'TIb'Y that I have no intention to relu~~n •to my former domicile, nd I intend to remain in ,•~ k~Ohf~' ~i?Y~RC)i;.~~'A~' .l".~G~' COUNTY, FLORIDA, permanently. ~• A, ` ~~ ~ , J• n,. ~ ~ [Nam . ~ • ; ~~~• .' Joe J, 3 ona ~r • ~• -- ~~~` (Address] • , , ;: ~ , is ' :r' Sworn to`nna~stYbscrfbed before me :.t-.is_ 18t~-- day of ~av~b9r - ls_ 82 ItCGER POI'I'RAS - - -- (.'I.~:RK CIRCUIT COURT Notary rablic 3y ~~~~?d~d~ D.e. i5ty Commission expires [Tn be ezecnted to dr:ptttate znd original file:i with Cleric G!reuit Goart, ands dupldrate with lax Assessor]