HomeMy WebLinkAbout0238 ..i.~•' ~l.....Y .~y -.r:..-~ -!i•~.:~'.r- sf s.. •y
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~ Decla~atlon ot Domiclle a~d Citisenship '
~ 1.32380 '
TO THE STATE AND COUNTY TAX /~~SSESSOR~ ~
! ST, ltJC1E COUtVTY, FIORIDA: ~ . t
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Thit is my dscla?ation of Oomicils and Citisenthip In ths Stat~ of Florid~ that 1 am filirq this d~y i~ aooordana and
~ in oonformily with Chapte~ ~22. Ssction 424.17, Flaida Statuht. '
~ i wa~ fame~ly • leqal rostdent of ~ Queens County ~ New York
. . (City) - tStat~)
' ~ 24311 129 ave Rosedale , ~ ~w ~
(St~~et and Numbsr)
b and am ~nd haw bssn ~ bona fids ~ssident of the Stsb of flortda ~ino~ 29t2i ~ -
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~ ~ ~pril ~ ~q 64 61? Coconut Ave. ~
, . and I roside n
` (Strs~t and Numb~?)
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!'ORT M~CE, SAINT Lt~C1E COUNTY, RORIDA - . .
a~d this stateme~t is to be taken a: my decluation of dtisenship, aduai Ipal ~esid~na and domkil~ in fh~ StaN of Horida.
~ pnse?t F~re any psrtlns~t facts, such as sale of propery or bu:,ineu, or nlirqui~msnt~of ~mpiayment
at former domkile, r~emove! of family to new dornicile, purd~ass ot hans, st~.) ~
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' Establishing r~sir~encq ~
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' ROGER POITRAS, CIERK ~ ~ ' `
~ ST, ttICIE COUNTT. FLORIDA ~ ~ ~ ` ~ ' ' `
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1 FURTHER CEltTIFY that 1 wlll oomply with ail oth~r r~Qulnrrwnts of a Ipd ntk~M of fhk Stat~.
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~ `~1 FURTHER CERTIFlf_ that I have no intentton to rotum ro my formsr domtdie, ar~d I tntend to remain i~ FOR'T
~ PIERCE. SAIIVY~LU~IE•~OUNTY, fLORiDA, permanently. ~ . _ - - -
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~ ~ ~ ~ ' ' . . U i • ~7 .
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~ . ~`^-a ±n~•;~ _ .
~ C~therine Alesaader
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'~'''~~•..C 0 . • F~Q'~~ (/?dd~ss)
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~ 8th ~ January 6S
~ Sworn b and aubsaibsd befon rr~t thb day of ~q~
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~ ROGER fOfTRAf
~ . qRCU1T~~URT
, . Not!ry Pubik
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~ 0'~? O.C. My Conw~~iuion ~xpir~
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~T• b~ ~oaa~~d ~ deptlcaM a~d ~iw~i Rt~d wiM~ Cf«k CMnrit C~re1, ond dMpp~a1~ wtlM Ti~c A~rJ
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