HomeMy WebLinkAbout0274 ~
; Deala~atio~ ot Domicll• and Citl:enship ~
_ ~ ~ 122g02
TO THE STATE AND COUNTY TAX ASSESSOR,
~ ST. llJC1E ~OUNTY, A.ORIOA:
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~ Thit is my decluation of Ooeniciie and Gltizenihip In ths State of Florlda that 1 am filt~p fhls day 1~ aooordanq and
in oonformity with Chapter Z22, Settion ~22.17, Florid~ StatutK. ~
I w~s formsrly s te9a1 ~esident of ~ew ?0!~ dlt~ _ l~
(City) (Stah)
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and 1 tesidsd st _ _ $1~S $'~i. R~~~OIIQ L~e • ~ ,
. How~vsr 1 hav~ charqsd my domidl~ y~. .
. (Sn~ef ~nd Number)
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to ~nd am ~and hsve been a bona fide resident of the StsN of ftorida tino~ ~~th day of
.
Deo eab?sr 43 1907 a~l~ptn~ A~e. :`4
, 19 , and I reside at
(Street and Number)
~ n~, sr~ tuc~ cou~n, aoaow
and this statarm~nt is to bs taken a: my dadaretia? of dtiunship, actual le~al r~idencs and domidle tn the Stete of Hortda.
(tnsert hen any pertinent fach, such es sale of property o? buslness, a rolinqui:hm~nt of emplaymsnt
at fonner domicils, ramoval of family b new domicile, purchase of ho~r~e, atc.)
~
~ ~ppl~i~g !or residsnoy •ad ha4e~ts~d
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~ ; ~ 1~502
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p ~ Fll.q AND RECORDED
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~ : ~i_ 19~~ Jr:t~ 2 10: 36 -
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. -.-;s~~~~~,.~o ~ eROGEIE C~UNTY F~LDn
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1 FURTHHt CER'T1FY that 1 will ropist~ at my locai address wh~n fh~ ro~isnatio~ books reopen, and oomply with
ali othss roqutremenri of a lepal resic{snt of this StaM. ~
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' 1 Ft1RTHER CERTIFY that 1 have no intention 1o retum to my former domiQil~, and 1 intsnd to remain in FORT (
; PIERCE, SAINT LUCIE ~OUNTY, FLORIDA, permsnently. !
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