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HomeMy WebLinkAbout1129-- .. ~_-- dJ~ti ~U "rAtr~~~ Ue~laration cif pomicilt and Cit~e~hi~ ' ' ~ l TO THE STATE AND COU1`iTY TAX A9K1Ci:~iSOR, 3T. LUClE COUNTY, F7~OItIDA: _ This b m?' declaration o! Domicils and C!tlsenehip is the State of Florida that I am fuinit this day in accordance _ and in cenforn,ity 'with Chapter ~ZZ. Section ZT2aT, P'tor£da Statutes. Calias I was former>,y a loyal reaiaetat ot_ Ieity] River Roa d and I resided at ~--- [S'.reet aAd Number] ~ and am and have been s bona fide resident of the Bate of Floridp siacv seine sate Howevtr, I have changed my domicL`e 21St day o: NovetDber I9~ ~2ana I reaiae at - 921 South 7th Street ~. - -- tstreet and cumber] FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, . and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile Ln the State of Florida. [Insert here any pertinent facts, such as sale of property or busine:s, ar relinquishment o1 employment ` at former domicile, removal of famlly to new domicile. purchase of home, etc•] Entering D~1vid Euguene Satith ~in the 4th grade ~1.~~~ ~~.. FlIED A~ RECQKD~ •• . ~ ~P'._ ' a~~K . `~,~• .tU:~J.~ ,- ." ~~~t Nov 2s aM $: 27 . ~~`,:~`~ ~~~r~}'.`I•./-+~R~GER p01?RAS.CI.f.RK ~~ = ~"• •~-~ ~,~ S'(. lUClf. COUNt'I. Fl4Rl A 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 FLJRTi-IER CERTIFY that I have no intention to return So my former domicile, and I intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently, ~~ - ~ ~E~ [Nam ] Mre. ~iaurioe ~ Smith [Address] ?.vth <~ :` ~ N©vweb®r Is 6?. Sworn to and subscribed brio: a me this iay1 of ' ~~" ~ , `~ .. ) ~ ~ . ROG POITRAS • ~~~~ 'cam ~ ` ' ~-'r---- 's-~----~=----- RK CIR IT COURT -. '_'~`~.:' •- '` r '' ~ i ,~ Votary Public 3 Q D.Q; . ~; '" :#y lCat~misaidn• ~F:rdi/r;-- - A ~ 1 ~ ~ ~ 1 - . ,. 4 ~~ (To 1-e executed to doplleate and ori=inssl file3 wit!- Cif ix'S~°~i'~si~d, aoplksle adtl- Tag Assessor]