HomeMy WebLinkAbout0462 D~ctaration~ of Domicils and Cittze~ship
TO THF STATE AND COUNTY TAX ASSESSOR, 1g18Q4
ST. lUC1E GOUNTY, FIORIDA: ~
This is my decla~atic+n of Domicile and Citizenship in the State of Florida that I am filing thi~ day in ecoordanos and
in oonformlty with Chapter 22Z, Settion 222.17, Florids Statutes.
1 was tormerly a leqal resident of x~9ustt,s xiChigati
(City) (Stah)
and 1 rosidsd at 1020 NoY'th ~th atrest . Flcwever 1 have changed my domidle
(St~eet and Numbe~)
ro and am and hsve been a bcN?a fide'residsnt of the StaM of Florida since 6~ - -d~y of
l , 19~_, and 1 reside a~~o5 ~elon ~ourt- Qraage Bloaaam 8st. ~
(Street and Numbsr)
FORT M~CE, SAINT L1K1~ COtlNTY, RORIDA
and this staterr~t is to be taken as my dedaration of citizenship, actual legal residence and domicile in thp State of :~orida.
pnsert here any pe~tinent facts, such as sala of property or bu:iness, or relinqui~ment ot employment
at former domicile, removal of family to new domicile, purchase of home, ets.)
~pplying for haneatead
F~~EO aNO RE p;
ST
RE ORD YERI~N~~
~ 1518Q4~
_ '6~ JAp 1 I P~f 39
ROGE~'~a°~
~LERK CIRCUIT COURT•
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1 FURTHER CdtTlFY that I will oomply with all otF~ requireme~ts of s le~al resident of thk State.
1 FURTHER CERTIFY thst I heve no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ ~ ~l R~ ! c~'• ~ ; ~ndrex I.obanov0 Rostovsky
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Svi?o?ri. AtMl~wbsuibed before me this u~ day of - JanB~ury , 19 6~ •
ROGER rOli'RAS ~
CIRCUR COURT Notary Publk
B °~-G ~ D.C. My Cornmiuion expires
(Te bs ac~N~d ie dupUcata aMl ori~inal fii~d whh q~rlc Cira~t Court, aed ~piiuh wilb Ta~c Ase~o~J
- aooK164 ~ 46p
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