HomeMy WebLinkAbout1546 ~ i~
. ~
O~c1a~aUo~ Ot Da?miail~ and Citisenship ~ ~ ~
' ' r
~
TO THE STATE,AND COUNTY TAX ASSCSSOR, :i.~~3~
ST. IUCIE GOUN'iY. FIORJpA:
~
! ~ This is m~ cl~cl~ratlon of Oomidls a~d Citi~nship tn th~ Stu~ of Florida that 1 irn flli~p thtt day M~ooordar~a and
in conformity with Ch~ptu ~~'l, S~ction 2Z?.17. Notida Statut~. ~
~
~ ~ wu fornwrly • Ip.1 ~e~td.nt of W~tsrn 3prings _ niinei~ T
(CtM) lSta»)
~~d 1~tded ~t ~561 iilo2~! Eoad Hovwvar 1 h~w dwn~d niy domWle ~
: - . (3ttNt s~d NeiMbsr)
~ .
- to and am and haw be~ a bau fki~ nsid~m of ths St~h of florida stna ~ day of
;
M` .J~..'__,_.,._„ 19~.., and I nsid~ at 1010 (~innL R~~_.
(Stra~t and NumbK)
.
l~ORT l~C~, SAMIf LuCI! t~OUNTY, RORnA ' '
F and ti~ts ttat~rrisnt ii ta be taken as my deduatbn of dtizauhip, adua{ Ipal r~sid~na and domidl~ i~ th~ St+t~ of Horkla.
! pn~t here a~y pertinent facts, such as al~ of propKly or busin~u, or ~linquishn»nt of anp{aym~m
,
i at formsr domkite, nmovil of family b nsw domidll, purcha~ of hane. ~tc.~
Plaoe (~ild in 3ahaol ~ ~
~ Will~ A. ~Iernlnnd 1~ years old .~sy.,
` ,
~ . FN.EO R . '
~I....,~ OOK
' 196k AUG AM i~ i 2
;
~ ~ . ~ R06ER.POITRAS. p.ERK
~ . - ST. ldCIE CCIlNTY. FlBt A.
; , I
. . ~ ~
+ . 'ti!~4
. . . ~ ~ .
j . . , . . ' r
.r !}N
~ _ . ~ ~ ~ ~ ~ 1R yi;~` :4~
i . - _ ~ i,~~,,~~'~~_~~~ .,r
i ? f ~ s.?' -
. j •`.~,,.~,•r , ~ .
• ' ' ~ ~r~~~~~J •
, •
i - fURTtiER CERTIfY thit i will comply with ;
; all athK nqui~Mna~n of a Ip~i ra~idsnt of thi: State. _ t
~ I FllRTHER CERTIFY thst 1 hsve no intention b retum to my fornur domidis, and 1 Intend ta remsin in F4RT
~ PIERCE, SAlM' WCIE COUNTY, FlOR1~A, permanantly. -
1
~ ~
~ .
' tHame) I+~ca. Jo~r, i~. Hexnlnnd
10~10 C~i~la Rosd~ Ft, pisrce~, P'loride
. ° . U~ddnas~
,
Swotn q and wb~ail~d b~ton ~ thb li1'ih.. day o~ luonr
t_ , 19
. ~ y~!~,•~,' -
~OOHt ~011RAf ~1,.r•••rt +
p ,1~* ~ ~
- ~K WN~t r j• ~ •~?'~i? • Nbtary-Pdb{ic
. • ~!i 'T' .~s • ~
a? ~ ' My Gorrm+iuion ~cptra
. r s ~ ~
. , f#.~•~~•, . ~ . ` ~ ,F
~ ~
~ tT. .o~.w~.r i~ ~NcN~ ~
`.~i~ •ti{~ ,rili~ a.~c ciro~~1 . .w~ ~Itat. wiN~ T.ac Aw.~..~a .
~ e~~~ 9~ r~cE3~5
~ ' - - ~