HomeMy WebLinkAbout1593 Declaration ot DomlCif~ and Citlzenshlp 9~
1~8684
TO THE STATE AND COUN~Y TAX ASSESSOR,
Sl. tUCIE COUNTY, FIORIDA:
This is my declaration of Domic;le a~d ~itizenship in the State of Florida that 1 am filing this day in acca~danoe a~d
~n confo~mity with Chapter ?~2, Section 222.17, Florida Slatutes.
I was formeriy a le~gal res~dent of ~RIOI~1 _ OHIO
(Ciy) (Stats)
and 1 resided et 820 Sheridan Road ~we~er ~ have char~ed my domtule f
(Sireet and Number) "
to and am and have been a bona fide ~esident of the State of Florida since _ 1St day of
_~g~ embe= ,~9 45~, and 1 reside at 40b UTillows Avenue ? Ri ver Park _
~ (St~eet and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declarotion of citizenship, actual lega) residence and domicile in the State of Horida.
(I~se~t here any pertinent facts, such as sale of property o~ business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
, ~i~ ,
i
~~1~Q AND R_ ~p
8T. LtlCIE C~E~TY' ~Rts~A:' .
RECORD ERI~1~0 -
_,~I~~~?,G~.l-~
'66 SEP 26 IW 10 Z9
3
ROGER9P~~ITRAS
c~aK ciRCU~t couaT
1 FURTHER CBtTIFY that I will oomply with all other requirements of a legal resident of thia State.
1 FURTHER CERTIFY that I have no intention to return to my former domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
:~1+;~~rj`'',: ,
. . • .
~ ~s ± • . (Name)
` ~
, _ , ~ -
. .:r~. , -
~ 406 Willows Avenue, River Park
•
~ : ~ ~ Ft.Pierce (nddress) St.Lucie County
. . ,
, :
SiNp~n~~~ti~+~p~'3~ubsaibed before me this 26th day of - September ~q_~6
.
ROGER POITRAS
CLERK C RCUIT COURT Notary Public
BY O.C. My Commission expires
(To bs ~x~cw~d in dvpliub snd ori~inal fil~d witb qerk Circuit Cou~, and dupltcab with T~x A~sror.)
SooK155 3~
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