HomeMy WebLinkAbout2226 - - -
. #
~
i
~ +
Oealaration of Domt~il• and C!tlssnshlp ~
133~
TO THE STATE MID COUNTY TAX ASSESSOR, ' ;
S'~, ltJC1E COUNTY, FLORtdI?: " ~
This it my decl~ration of Domicile and Citise~ihip in th~ St~te of Florida that 1~m filinq this day in ~ooordano~ a~d :
1
in aonformity with Chapter 22Z, Ssction 222.17. Florid~ Statut~. t
F
1 w~s formsrly a le~al rssident of LOdi ~ n~; ~ ~ '
. • (City) .
i
. ,
' and I r~ided ~t R~ • i4~1 How~vK 1 h~ve chanqsd my domWl~ ~
i
(Str~et and Number) ~
b and am a~d have b~en ~ bona fide ro~ident of the State of fiorida s~noe 19 - ~y ~ i
~ ~ F b ua ~
e r r~ y ~q 65 and I roside ar Rtoue 3 Box 490~H ,
(Sheet and Numbs?) '
l~ORT t1ERC~, SAINT LUCIE ~OUNTY, RORIDA - ~
f
and this stateme~t is b bs taken as my dedaration of citizenship, actual legat residenos and domicile in the Stats of Horida. .
qnsert hero any pe~tinent feds, such as ~ale of propery or businsss, or rollnquishment of employment •
at fo~mer domidls, removat of family to new domiute, purchsss of horr~s, etc.) ,
~
~ Bntering children in 4th and ?th Grades
133~22 ~
. p. DEO . . ~
~ Fl ~~~1~~~ QOOK . ~
~ ~ • o~''''•••. ~
49 ~3,......,, ,,a - ~
8 23 AM 9: , ~
1965 ~ = o ~
~ • : - = ~
' POITRA ~ ~ ; r= `
_ ROGER S'~RDA ' ~
Sj. lUC1E COU~itY. fl0 - . _
d:u~ ' ~ •
.Jt - ~r ~.!~rr r =
~ • ~
OJ i~ ~R~ ~
r
.
i FURTHER GERTIFY th~t I wltl aomply with sll other roqulnmMb of • lepal rosid~nt of th~ Stat~.
1 FURTHER ~ERTIFY that 1 have no intention to ~etum to my former domic~le, end I intsnd to ~emein in FORT
PfERCE, SAINT LUCIE COUNTY, FLORIDA, pemnanently. ~
,,,~,~A~I~I.,~~~. ~ , .
GU I ~ ~ -
rr`G~? c. . ,
i . . ~ .
: " ~ . ; : ~ (Name) .
: A ~ :
~ ~ ~ r ~ . Dorsie Hurlc~
~ • `t , (I4ddress)
s~ /i.:~ • '
' ~bM.~Co.: ea~'wbxrib.d b.for~ rn~ t~ets 23 ~ de ot Pebrusr 19~: ~
, . Y ,
~
~ ROGE~ ~ORRAi • . ~
+
~~l~~T ~ ~btary Pubik ~
/ ~
~ c c..~~ : ~ O.C. My C.onwntstion ~xpires !
- ~T~ b~ ~oawMd M dvpticaN a~l aiaiMl Ai~d wMl~ CfMk CMa~it Gw~, u~d ~ptkNs w~ Tix A~ra
' ' IB(?~ ~fd~~ r
_ _