HomeMy WebLinkAbout0587 Oeclaratio~ ot Domlcils and Citizenship "
TO THE STATE AND GOUNTY TAX ASSESSOR,
St. LUCIE ~OUNTY, HORIDA:
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Thii is my decla~ation of Domicile ~nd Citizer~~ip In ths State of Flwida that 1~m filin~ this day in ~aoordano~ ~nd ~
in aonformity with Chspter 2ZZ, Settion 222.17~, Florida Statutes. !
, 1 was forme~ly • te9a1 resident of _ ~iio
(~iy) (Sta»)
and 1 rosided at ~u~ 5 . Howevsr 1 hav~ cha
_ nqeJ mY domldi~
(St~eet and Number)
ta ~nd ~m and have baen a bona fids restdent of the State of flo?ida tlnos day of ~
Februts~'yr , 19 snd I ~estde at aonte 4 Bo~c 408
(Street ar~d NumbK)
?ORT MERCE, SAINT LUCIE ~OUNTY, RORIDA ~t
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and this statement is to be taken as my decleration of citizenship, actvai leqal rasidenos end domidle in the Stats of Horld~.
(Insert here any pe~tinent facts, such ss sale of property or business, or ~elinquishm~nt of employmsnt
~ at former domicits, mmoval of femily to new domicile, purchase of lwme, etc.)
~
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Establishing ~e~a~r f11.ED 1~,P! E ~fD .
~r~ ~j[~~a~ _.~OOK
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~ I 196~ J~~~ 2a FM 12: ~8
~ ROGER POITRAS, CtERK ~ ~
. : ~ ST. IUCiE COUNTY. F~ORIDA ~~f
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i HIRTHER CER?IFY that 1 will rogister at my Ixal ~dd~ess whs~ ths ro~isttation books reopen, ~ab ~ • •
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a!I othsr roqutrements of a legal resident of thi: State. . ~
,
_1,. .~1RTHER CERTIFY that I have no intention to retum ro my former domic~la, and 1 int~nd to remain in FORT
PI ~~if't1~C1~ COUNTY, FLORIDA, permanently. •
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S~wot~+ sa and wbscribsd bafor~ m~ this dar of lq .
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~ C R ~ary ,1 ~ FRC~vO~
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dp D C. My Corruniuion expires•-- - ~
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lr. r..x.whd M rupik.~. aaa e.i~l fi~d whb a.irk ciraii~ co~et, .nd d~::~.-sa wNh T.x A~..»..a
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