HomeMy WebLinkAbout1811 ---'+.~rr ' •aAia~+rMr.t..• ~.a-~ ~
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• O~cta~atlon ot Domicll~ and Cltis~nshlp
133?~"7'?'
TO THE STATE AND COUNTY TAX AS.SESSOR, '
ST. WGIE COUMY. FlOR10A: . '
Thb is my d~cluation of Oomidl~ and Citin~nship in tl+~ St~t~ of Florid~ that 1 am filinq thi~ d~y in ~aoordina ud
i~ oonforrrilty with Chapta 2?Z. Ssctbn 22Z.17, Flaida Statut~s. ~
~ 1 was formsrly a Isqsl ~esident of ~~rth AmbOp ' N~w _jrree_v _ ~
(Giiy) (Stah) ~
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~ ~ ~t 215 State Street ~ ~K ~ ~ ;
(StrNt ~~d Numb~~) ~ ~
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b a?d am and I+~w bN++ a bona fide resid~M of the Stat~ of Florida sina la t ~y ~ ;
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December ,~9_.~ and 1 resids at 619 Ash Str~•~t _ pn=t ~.LuSi•
, . (Stn~t and Numba~)
l~ORT M~Cf, iAp~1T ltIC1E COUNTY, RORIDA
~nd this :fat~nt it to be take~ as my dscluation of citi~nship, actual Ipal ~aideno~ and domidl~ in th~ Sht~ of ffortda.
Qn~t hero anr pe~tinent facts, such ss sela of property or bur:ineu, or ~e1l~quishn~sM ~of ~mploym~m :
s
it forn~ domicile, romoval of family to new domicile, purchase of horns, Nc.)
. . 133?2`~?' .
Bstablishing residency ND RECORDED
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i~~~~~„~„~~~~+ ~ ROGER POITRAS. C~ERK
ST. ldC1E COUNTY. fL1AIDA
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y 1 Fl1RTHER CERI'IFY thst I have n~ intention tc r+etum to my former domicil~, and 1 intsnd to rom~in tn fORT ~
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PIERC~ SAINT lUClE GOUNTY, FLORIDA, permansntly. . • {
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~~~'~UC~~~l1~~~nd
wb~crtb~d bffori m~ ~his 12th ~y ~ F~bru~rY_ ~ 19_b~. ~
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, ROOER rO1TRA: .
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