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HomeMy WebLinkAbout0999 ~ De~laratlon of Domicii• and Citise~ship ~ , ~ TO THE STATE AND COUNTY TAX ASSESSOR, 15216•~3 ~ , Si. LUCIE COUNTY, FLORIDA: This is my declaration of Oomicile end Gitizer~ship in the Stats of Florida that 1 am filin9 this day in aooordano~ and in oo~formity with Chapter 222, Section 222.17, Florida Statut~t. ~ 1 was formerl a 1 ~iaahington D.C~ ~ y egel resident of ~ (City) (Sta») i ~ and 1 resided at 3?22 Benton St2~e9t N. ,~~,,,evsr 1 have chsnqed my domitile ~ - (Stre~t and Number) to and am and have been a bona fide ~esident of the State of Florida sinoe lat i day of dugust , 19_bG, and I reside at 21~09 N~ AtliRtiC Beach Blvd, (Street and Numbsr) FORT PIEItCE, SAINT LUCIE COUNTY, RORIDA f and this statement is to be taken as my declaration of citizenship, actual iegat re:idenoe and domitlle in fhe State of Hotida. ; (Insert here any pertinent fads, such as sale of property o~ busineas, or relinquishment of empioyme~t ; at former domicile, removel of family to r~ew domicile, purchase of home, ett.) wp~lying for hamestead and establishing residence FILED ANO RECORG~O~ , ST. LUCI~ COUNTY. ~LA. ; RECORD VERIFtEO ~ js21s3 '6t JAN 25 A!1 10 : 29 ROGrR POITRAS CLERK CIRCUIT COURT ' 1 RJRTHER ~HtTIFY that I wiH oomply with al! other requiraments of a lega! resident of this Stste. i ;f ~ I FURTHER CERTIFY that I have no intention ta retum to my former domicjfe, and t intend to remain in FORT - ~ PIERCE, SAlNT,,~UCIE COUNTY, FLORIDA, permanently. '~ii;1Ntil:?r;; ~ ' ` ~•'~ti , t • _ ' O~~f:/' ^ r f ~ . ~ ~l ~j, . / ~ ; ~ ~ ';i~~~~,'~ I~cG (Name) ~ _ ~ ~_i ,;-JG's~'. : Joshua Thaada ;:o ~ ` U~' J~'l. • € - ~ ~ , (31'sce B• ~'ouqg ) j ' Sworn to and subscribed before me this 2s~ dsy of danuary 19~_. . l ~ Roa~e rom~?s ~ : ; CIRCUII' CAURT Notary Public ~ ~ ac.c~~ CO - ~ 8y D.C. My ~ommission expires f t { S ! E (To b~ ~x~euNd in duplicat~ and ori~inal fil~d wi~h CIKic Gra~it Couh, and dupiieab witb Tax As~or.) i i , OO~ P~E ~ 1 ~ n`rs'.~is 5 - . . Z, ~ . : . _ _ . . _ . - _ '~u~ 3'"wr,~'.< + V"°` 3.~ ~ .7 • . : ~ _ r~ -,r _ - _M:T '