HomeMy WebLinkAbout0508 ~ ~
t
: 4
~ ~ Decla~atio~ ot Domtcile and Cttisenship
~ - ~ , ~
. _
: TO THE STATE AND QOUNTY TAX ASSESSOR, ~
ST. UlC1E GOUNT1/, FtORIDA: ~ t~~4
. j~?~G ~
This Is my declaration of Domicite and Citi=enship in ths Stste of Florida th~t 1 am filirp thit day in aooordano~ and
+ in aonfamity with ~hapter Z22, Section 222.17. Fiorida Statute:.
I was formerly a legal ~esident of ~i~'~'e _ 86rtttiCl~ ~
. Kity) (Stat~) ~
and I rosided at ~8~
. Hovwver 1 have chanqst! my dornWM
- (Street snd Number)
' to and am and have been a bons fide rsaident of the Ststs of Florida sinoe ~y ~
t
! , t9 and t reside ~et 3225 1rli~a Di'l.v9 _
. (Sheet and Number) _ y
' H ~
, .~ORT MERt~. S!!!NT Lt1ClE COUNTY, RORIDA ~S ~
end this statement is to be iaken as my declarstion of citizen~ip, actual leyal re~ide~os e~d domidls In the Sh1s of Horida.
pnsert here any pertinent fact:, such as sale of property or busineu, or relinquishrr~ent of employm~nt
et fo?mer domicils, romoval of family to new domkilq purchase of horns, ett,)
: . .122~~ -
~
;
~ FILEO A~dD R~C DFD ~
' p~cial-R . .~OO~
,
,
" 1954 J~~~ 25
i Eatabliahing reaidency Q~ OS
~ . - RO~~R POI~RAS. CtER ' l
~ - ST. LU~fE C~U,if~r, FtOR10
,
; ~ ~ ~
, . .
~
~.,a;,~, w ~
r!: ~~`'+J~ ~ ~ ~ ~ V~~~" :;i 'i i?
. 13;;......, / • ~ .
, •r,~ .J . . J ,
.1.. : ri,-~A~",•,~,
~ ~ t
•e . ~'r. . ~;~~t;.. , -
r.
. ~ _ ~ ~ '~<il.~ ' ~r ~ r
: : d ,~i ~ W,~• _ -
- :'r:~~;~.--~^_~
t .
6 .
1 RJRTHER CERTIFY tfiat 1 witl repister at my locat addres= wfisn the registration books ~.iy~~p~*~h~
all othsr ~ •
. roquirements of a legal rosident of this State. ,:~'•ti;,-,t/~ ~ ~i~,,~.~'.,
. ~
. ~ , y~
~.,.r+,"s
~~'.'.,t ~ -
' t FURTHER ~ERTIFY that I have no intention to retum to rriy former domidle, snd t intend to remain in FORT
PIERCE, SAINT LUCIE COUfVTIf, FLORIDA, permanently. ~
, . ..1t.~:; . ~ .
, ~~v ~~o~~- . ~
~ ,v~Avv~ . l ~ (Name)
! ~r S~ O ~ -
- - r; . . ;
~oy!; r~~ . ' T-_
. tL~'~t~:_'!`~`f:[~~~'
-t~.-ir. ,r' ~ ~ J ~ W~e L~ ~6"~J
. r i'~.'•- ~~F " .
: -~;~~J; : ~ -
:~._,ti~ ~
~r = ' (qddrssi) .
:
' = 4i~'
; -~.~:.~.~1 u .....•CO.. -
:•,~r. C ~ F . : ~ ~ ~
! 'S~worn. fo and subsaibsd beforo me this ~ d~ JaiuB 19
i
~
~
~ ROGER
i 1 UR COURT Nota Publ {1
! {
ry ~Q~K ' ;~~f i~~::5~t7 ,
~ 6fl D.C. My Gommission expires
~ ` Y'
(Te"S~ ~oc~hd in duplicah and eei~inal fll~d with ~iKlc qrark Coue~, and duptic~ta wiM~ Tax AsWa~ora
1 -
i
~