HomeMy WebLinkAbout2530,..,.~~
- b~K J~ e~s~ ~~~
` Dcclarati+~g R~ t~p~#i~'R. fiE~Er.} Ci*_lzcnship
TO THE S'T'ATE AND COUNTY TAX ASSESSOR,
3T. LL'CIE COUNTY, FT..oRIDA:
This is my declaration of Domtclle and Citizenship in the State of Florida that I am fUing this day in anrordance
and in conformity with Chapter 222, Seaton 222.17, Florida Statutes.
CHICAGO III,
I was formerly a legal resident of
[City] State
and I resided at 1122 S. MenArd Ave.
[Street and Numbed
to and am and hac~ been a bona fide resident of the State of Florida since
Novecabex __~ 192 and I reside at
FORT PIERCE, SAINT LUCIE COUNTY, FI.oRIDA,
. However, I have changed my domicile
27th ~, of
735 Airoso Blvd
[Street and Number)
and this statement is to be taken as my declaration of cttizensh ip, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts. such as site of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile purcl.ase of home, etc•)
;~;:;.
~~ r ~~ ~.
j~~' ~ '\i•.1~.
~~~ ~: `, ~
111432
INFlL 'dal ECO DBOOK
1962 DEC 20 AM 10: 37
ROGER PO{TRAFLORIDA ~
ST. LUCIE COUNT'f,
I FURTHER CERTIFY that I will register at my local address when the registration b~oks reopen, and comply
~:
with all oti~`'s~quirements of a legal resident of this State.
' ,~„~?'~ RTIFY that I have no intention to return to my former domicile, and I intend to remain in
,'
!,
~: ~ '~i+TT LUCIE COUNTY, FLORIDA, permanently.
,'~.~t"Y;y~~'~;: ! .-' T~ y}gyp _~-[,7Name]
SY:i^F'~i: S~~ r• `: i ~ _ ~~ ~ ~ •" ? ~~_ ~ J.,CIQ F • Tfla'bLLL~LiLL~
•~J' fit, ~~;,(~ Q' y_-
~5 ^~ w
~~ ~`hl,~~ ~ t. _~~'~~~.._;- 20th
`^,.„~4, `~ttbscribed before me this 3sy of
y~.
'. R CFI: PO
F.RI{ C CUIT CO
[Address]
December
' .Notary Public
82
19__~_
3y ~' D.C. My Commiesion c.~cpi.r
[To be execnt~ in dnpticata aa+3 original tiled with Ukrh Ciren# 4onrt, and dupUcste with Tex Assessor]