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Declaratio~ ot Do~nlcile and Citizenship
- _ - ~ . iy`~. 1516"72
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TO THE STATE AND COUNTY TAX ASSESSOR, • "
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of ~omicile and Citizenship in ths StsM of Flo~ida that t am filin9 thi: day in aoo~rdanos and
in aonfo?mity with Chapter 2Z2, Section 222.17, Horida Stetutes.
1 was fo~merly a leqa) resident of ~etroit ~~Chlg81'1
(City) (Stats)
and i ~esided at 14880 Westwood Street Howe~er i hsvchanqed my domidls -
~ (St~eet and Number)
ro end am and have bee~~ a bona fide resident of the State of Florida since _ lst ~y ~
~ugust 66 179 Soneta Court Port St.Lucie ~
, 19 , and I ~eside at
" _ (Straet and Number)
= FORT M~C6, SAIN? LUCIE COUNTY, ROWDA
and this statement is to be taken as my decla~ation of citizenship, actual legai residen~e and domicile in the Stats of Horida.
(Inse~ re any pertinent facts, such as sale of property or buaineu, or relinquishment of employrnsnt
at former domicile, removal of family to new domkile, purchsse of home, etc.) .
. ~t~ ~1l0 RE.
Bstablishing residence ST'~CORO VERil~I~ " ~ ~ ~
15~.b"?'2 -
'6t JAM 9 A!1 8:35
ROG R POITRAS ~
- - . CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that I will aomply with all other requirernsnts of a Is~al r~ident of this Stste.
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I FURTHER CERTIFY that I have no intention b retum to my former domicjle, and I intend to remain in FORT
PIERC~~'~f~1~1L~~ CdUWTIf, FLORIDA, permanently.
~l,t~ -Cp~ii~,• : r--~
J``, yjj~;:y~•'ci;~~%
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_i.~~{-~ ~ G ~ _ ~ Mame) i
_ ..a~;?'.-, r?• • _ Roy T. Fitzgerald `
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V~ir(tP.1i~:=~.3~ _ = . .
~ ,'`~~~~C...-•~r'~~,•'~' (Address)
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~ .:est:i•``.
Sworn to and subscribed before me this 9th day ~ January ~ 19 6? .
ROGER PORRAS ~
CIRCUR COURT Notary Public
By D.C. My Commiuion expires
(To b~ ~oc~evhd in duplicats snd ori~inal fibd-witb Cl~rk Ci~a~t Cou~t, and duplisaf~ with Tan As~aor.~
~164 ~ 269
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