HomeMy WebLinkAbout2093 . " .
~ec~aratlon o! Dorr~iciie and Citizenship .
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TO THE STATE AND COUNTY TAX ASSESSOR,
. ST. lUC1E CbUNTY. FtORIDA:
This is my decleration of Domitile and Citize~ship in the Stats of Ftorida thaf 1 an~ fllirp this day In aaoo?du~o~ and
in oonformily with Chapter 222. Saction 242.17, flotida Statutts. .
1 was formerly a leqal ~e:ident of /~-a~ ~~~i~~° _ ~ .
(City) _ (St•»)
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•nd rosided . at ~ ~
- H~ 1 hav~ chsnqed my domidle
(Straet and Nun?bsr)
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~ . b and am snd havs baan a bona fids?~~ident of tha Stats of Ftorida stnoe '~a ' day of
v , 19 and ! r~ide et ~ ~ ~ l.s ~
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I~ORT PlQC~ SAlNT LUCIE COUNTY, ~IORlDA ~
and this~:tateme~t i: to be taken as my dads~ation of dti~enship, sctval le~al residenos a~d domkil~ in fhs Sta» of HorJda.
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' pnsert hsire any pertinent facts, such e: sale ot property o? bu:ir~u, o? relinqulshment of smploymsnt
at f~ormer domic1ls, removal of family to new domidle, purchase af lame, etc.)
. ~s%'~~ ~/S /y/,,~~ ~s' -/~c~ .128 .
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- FIlEO AND RECORDED . . ~
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. 1964 AUG 18 pM 9: !~3 .a. ~;r:_ ' ~ ~
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ROGER POITRAS a ' i
~ ST. IUCiE COUNTt. F QRIDA.
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1 FURTHER CERTIFl( that t will ~y ~
atl other reqvirements of s laqial rosldent 6f this State. ' . - I
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. . 1~l1RTHER CERTIFY that I have no intention to retum to my ~mer domidie, a~d I iMend to romsin in ~K~` i
WERC'E, SAINT LUCIE COUNTY, FlORIOA, permanently. ` I
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~ Swor~ to ~nd subsuibsd beforo rn~ this ~ day of 19~~ '
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: ~ 1t. b. .~awF.d in aupHcal..~d .ri~i~af fif~d wi~ a.~ic araiN c,.~M, .nd depi~. wid~ t.x /b..~.xa .
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