HomeMy WebLinkAbout2011 ~?R~MrY •~Md~L•• ~ ~M M.~` r - T ~ • .
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Declaratlon ot Do~nicile a~d Citisenship o
TO THE STATE AND COUNTY TAX ASSES.SOR, ~ 1334U8
ST. Lt1C1E COUNTY, FIORIDA:
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Thts i: my daclsration of Oomicile and Citisenship !n ths St~te of Florida th~t 1 am filinq this day in aooordano~ and
in oonformity with Chapter 222, Section 222.17, Fiorida Statutes. {
1 wa: formerly a Isgal ?esidenf of ~~N ~ OHIO
(City) (Stab) ,
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RD 2 Forester Park ,
a~d 1 rosided at However 1 have c~arpsd my domidle ;
' (Street and Number) !
to and am ~nd have been a bona fide msident of the Stats of Florida sinoe 8~ dsy of ~
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Pebruary . , 1965 ~ end ~ ~es~de st 310 DickerSOa Dr. ~
(Street and Numbsr) ~
l~ORT MERC~, SAINT WCIE COUNTY, RORIDA ~
a~d this statement is to be taken as my declarotion of citizenship, actuat legel residsnos and domidle in the Stats of Horida.
pnsen here any pe?tinent facts, such a: sale of property or business, or relinquishment'of empioyment
at fotmer domitils, removal of family to new domicite, purchass of horne, etc.) ~
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$stablishing residence t*~t d and 13340g ~
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BNTBRING CHIT,DREN IN PUBLIC SCHOOLS ~N C18~0
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~ - IS~S FEB ~ g AM (0: 2p i
ALSX B. COA~S C 11 ~rs. ) RO G ER POITRAS, ~
~c JIMMIB D. cor~s c 7~rs.) ST• tUCIE COUNTY. FtORJpA ,
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! FURTHER CHtTIFY thet 1 will oomply wMh ail other requirernsnb .of a le~al rosiderk~o~ thh•~iSd'~~~ , ~
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1 FURTliER CERTIFY that f havs no intention to retum to my former domitile, and 1 intend to remain in fORT
PIERCE, SAINT LUCtE COUMY, FLORIDA, pe~manently.
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.-~^~i: ` . cName~
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~ : ~ ~ ~ ROY G BRINSON
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~ Sworn to ~nd wbsaibsd bsfore me this 18th d~y Februar7r ~ 19 6s ~
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a~c a uR cou~ , Nor.ry ~wk
~ D.C. My Gommission ~xpiros
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; j (Te b~ ~au~arMd M dupqeata and ve~inal Ai~d whb Cl~elc qrarit CouN, aed ~ wHh Y~c Awwe~~ .
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