HomeMy WebLinkAbout2443 :?'..•r~A~la .v-. rd.o' s .?t~' ~.~r~ -
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~ ~ Deciaration of Domiclle and Citizenship . ' .
~ TO THE S~ATE AND COUNTY TAX •A~SSESSOR, 128456
ST. LtK1E COUNTY, FIORIDA:
This is my deciu~tion of Oomidle and Citis~~ihip in th~ St~» of Florida that I am fili~p this day In aooordano~ and
• in ~fo~mity wlth Chapro? 2?~, Sxtlon Z2Z.17, Horida Statutes. .
1. wa: to~meriy . le~al nsid.nt of BprYBli eld Ohi o
(City) (St~h) .
2225 NoPpes Avenus
• ~nd 1 rosidsd at Howwer 1 havs chanqed my domkil~
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, to and am and havs bsan a bona fids rosident of the Staro of Florida sina 20 ~y ~
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_ Auguat 6~ 702 BraoY Roed
' 19__, and 1 nsids at
(Stresf and Numbs?)
, fORT M~. SAINT iUdE COUNTY, lLORIDA -
: u~d this statement is to ba taken a my deda~ation of dtizen=hip, ~ctud le~al rastdsnos and domidle i~ the Sta/e of Horida.
~ pnsert here any psrti~nt fach, such u sala of propsrty or butiness, or rolir~qut~rne~t of empioymsM
. at former domkiis, romoval of family to new domkile, purcha~ of home, etc.) .
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S~lntering children in 2nd and 5th grsdss
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; 128456 ~
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` ~ ' ~ ~ .~~-;t'... 1964 P 2: 48
' ' A!!G 24 M
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~ • - . : R06ER POITRAS. CIERK , .
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, , ST. IUCIE COUNTY, F~ORI
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~ 1 Fl1RTHER CER'TIFl/ that 1 wlll
~ all other roqui~smsnts of a Is~al ~Ident of this State. ~
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~ ~ 1 FURTHER CFRTlFY that ! have na Intention to retum to my former domWle, and I iM~snd b romain in FORT .
~ ``PI~,~ SAtI~T*IUCtE COUNTY, FLORIDA, psrmanenNy. - •
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rp~,~- .v~ • _ ~ (Name) . .
. J'~;.,,~Y".:1
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F ~ t t E to ' Rat?~eond B. ~rsrs
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~ ' $~WOfD 10 ~ i1~Wib~ ~fl~ ttlis : 2~ ~y pf A11R119ti '
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ROOER lOITRII:
` CLHtK COIIRT Not~ry Publk
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' ~ O.G. M~r Comn~iuioe~ *xpir~s
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