HomeMy WebLinkAbout1599 , _
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; _ ~eclaration ot Domiaile and ~It[zenship ' ~
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TO THE STATE AND C'OUNTII TAX AS.SESSOR, .
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ST. IIJCIE COUNTY, RORICW ` ~ . .
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This is my decia?~tion of Oonnidl~ and qti~nship in tM Stat~ of Horida that 1 an~ flli~q thh day in aooorda~ and
i~ aonformity with .Chapt~r ?22, S~dbn Z2Z.17, Florida Statuta. ~
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i~wa~ formsriy a Ipal rosident of 3T Ohio ~
t~Chy) ~Stah?
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~nd t ro:td~ct at 7652 d~csenland Place ~ ~ ' Howevsr 1 haw chanpsd my domWl~
1 (St~e.~ ~nd N~n~e~~ ,
• to and ~r+n and hsve bsen s bona Nd~ rosid~m of ths Sht~ af Florids stnoe ~ 1~ day of
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6~., and i resids at 416 3• Narsn~s, Port St. i•acie
_ ~ (5treet and Number?
~ !'ORT MERC~, SAINT UlCIE COUNTY, RORIDA
and thi: stat~ment is /o bf taken as my dedaration o# citiner~ship, ac~ual ipal rosidence and domidie t~t the Stars vf Horida.
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pruer? here any. p~rtinent fach. such as sale of propeMy or busineu, or mli~qui~he+nsnt of employment
af t~mer domidte, ~navai of family to new domitile. purd~aae of homs, ett.) . .
B~stablia~bing reaidency . ~~~4 .
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• ; : ' ; ~ ~ ~ 196~ FE815 AM it~ 12
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~ECtE CBYNRy S' ~ ~
F.~o'~~ . . Ft~R18A
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' 1 FURTHER CERTiFY that l will repister at my loal address whan the ro~isnation books reopen, and oomply with
~ all othsr-roquiraments of a tegat restdent of this Stare. ~ '
! FURTHER CHtTIF1+ thst ! haw nv lntention to mtum to rr~y former tdie, and I i to rematn in FORT
PIERCE, SAtNT WCIE COt1MY. FLORI~A, permanentty. .
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Sworn to ~nd wbscribed before me thb 1S~ day o# 19
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eY D.C. . s .ty expi~s
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; ~ (Te b~ ~c~c~+hd ~ dnp~ and ori~inal fiNd wba Cli~lc ara~t Co~rl, and doptieat~ wilb T~oc As~o~a
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