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HomeMy WebLinkAbout2431 .v •r~ A~\• •••r• •R" ~ _ _ _ - - ~ . f liw 1 , 4 Oectaration ot Domicile and Citlsenshlp 128~45 : ; TO THE STATE AND Q4UNTY TAX ASSFSSOR, ~ ST. llIC1E COUM'Y, fIORIDA: ~ ~ Thts is my d~clantion of Oomiale and CitizMShip in ths Stat~ of Florida that 1~m filinQ fhi: dsy tn aooordana and . ~ in aonformity wilh ChaptK ~2~, Secfion g~~.17, Horida Statutes. ~ , 1 w~: formsrly a leqsi rosWent o ~ _ ; (C~NI ' (Stah?) . and 1 titidsd at t`~ ~ ~ Howfver 1 hav~ chsrpsd my do~nWl~ ~ (Straet a~c! NumbK) ~ . . to and am and havs bssn a bona Nd~ rosidu~t of ths Stero of Florida sinoe z~ day of ~ ; ' o ' , l~ and ~ rosids n • •~/1 . - ' (5tn~t and Numbsr) ` i°ORT MERCE, SAINT LtIqE COUNTY, KORIDA ; and this statement is ro be taken as my declatation of dttzen~ip, actu~t leqal ~eside~os and domkile in fhe Stata of Horida. - p~sert hem any pertinent fach, such a= sale of property or busi~ess, or roltnqul=hmsnt of emptaymsnt ~ at fomnet domicile, renwval of family to new domidle, purcha~ of t~o~r~e, etc.) ' L~ , ~G.crv ~G/C,t~ ~ ~ . ~ ~ , • ~ ~ . ~ ~ - ~ ' ~ . ~~c ~ ~ ~ • . ' ~ ~,,......~,~1 - ~ ' . ; ~ ,,r`•• . . ~ j , ~ : r,~ ; : . ~~i ~ , -~84~g3 . j - ; . ~ : . ~ 4 : .i ~ , : • ~ : , : ~ ua~~r~~o~ ~ „ ,r rr,;.~~ ~ • - ~ . ~ . , ~ ~ ~ 80 K ~ . . : ~'~~v~~E~°~ . _ : 196kAU . ~ , . 6 24 A~1 !I. ~ g ~ ROGER POITRAS,a~ . ? . ST. lUC1E COt1NTr, F~ORtOA ~ ~~~cu~t ~c . . ' .s~vr~ - 1 FURTHE~-eC,.~.RTiFlf that i wili aor»piy with ~ atl oth~ir' requiremenis~of s le~al rostdent of this Stete. . ; ' . + '•~'!G I.fURTFiE1~{~RTIFY that 1 have no tntention ro retun~ to my formsr domidle, and I intend to remain En FOttT ~ PIERCE.' Sq{tsT ~.l1CiE COUNTY, fLORfDA, permanently. t _ i . ~ . , ~ ~ . ~ ~ . ~ me) i ~ . ~ ~ # ~ ~ (Addras) a ~ . . . . `1 SMrom b and sub~ribsd b.f~or. nn~ this °'ZT diy of 19 Gf~ ~ ~ . ~ . ! . ~ ~OITR/lf ~R Notary Publk ~ ~i i af? D.C. My Conw~niulon expir~s ~ 97 ~T. 6..onarl.a iw d~plie.~. ,wd .rtoM.i t~d wiM~ a~rk a.wN c.rrl, «Md drpNat. whl~ T.oi A+~......~ ~ _ - - • . .