HomeMy WebLinkAbout2284 ' • '
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Dacla~atton of Oomi~ii~ and Citis~nship ~
TO THE STATE ~?WO QOtJNTY TAX /1SSESSOR, ;
ST. lUC1E OOUNTY. FIORIDA: ~ i
Thh ts m~r d~cl~~ation of Oomidl~ a~d Citi~ship in th~ St~t~ of Fiorida that I an+ fllirq thb day in aooordana a~d j4
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in oonfamily wtth ChsptK 2Z2. Ssc~ion 222.17, Horrida Stahit~. - 4
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1 wa fortnKiy a Ipal r~sid~nt of - . t
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.~+a ~~id.a .t. ~a~ G~.t~•.~.! ~ ?+oM?.r.r ~ n.v. d+.nv.d nn? domwa i
• (Str~ef and Numbsr)
~ to ~nd em and h~ve be~+ s bona fide rosid~nt of the Stat~ af Florida sina d+Y ~
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19~ and 1 raid. a Y A~ _!G~! ~vv-•
~Stro~t a~d Numovri
lORT MERCE~ S~AINT l~IC1E COUNTYr!l~IORIDA - -
a~d thb sbtsrr~ent ~ 1o be takan a: my deduatbn of dN~nship, aclusl Ipal resid~r~o~ and domidl~ in tM Stat~ of Horidi. '
pr~sert hen any pertinsnt facts, such ss sale of propsrty or butin~u, or nlinqui:hR?snt of ennpkym~nt •
at former domidl~, removal of famlly ~to new domicile, purcha~ of 1+ome, ~tc.)
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~ .~s. i : 1964 MQA -
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~ ~ . z~'',~:~~: • ROGER POITRAS
E:i'.,, r:~ , St. tUCIE COUNTT. FIORtQA
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I fURTHER CER'TIFY that 1 will ropister at my loal sddross wh~n the ropist~ratioR books roopsn, and oomply wiM~
all otF~ roquiremenK o~ s le~al rasidaM of thb Ststs. .
1 FURTHER CERTIFY ffiat I have no iMentbn to rotum to my former domWis, and I intend 1~o ramain in FORT
`t PtERCE. SAINT WCIE COUNTY, FLORIDA, psrmsn~ntly. ~ . - _ • '
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