HomeMy WebLinkAbout0089 D~aluatio~ o! Danlail~ ar~d Citis~nship
TO THE STATE AND COUNTY TAX A,SSESSOR, 1~~~
Si. LUCtE COt~NTY, FIORI~A:
This is my declaratior~ of Oomicile and Citizenship in th~ Sta» of Norid~ that 1 am filinq this day in aooorda~a and
in conformity wiNs Chapter 222, Saction 2Z2.17, Florida Statutfs.
1 was formatly a leqal rosid~nt of ~t~ffalo 1i+a± Qirgin3a
- (CitY) (Sta»)
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and 1 rosided at Bo~c 216 B How~vK i hav~ chuqsd my domidk
(Stn~t and Number) .
ro and am and have bae~ a bons fids resident of ths Sbt~ of Florids :ina 18t day of
J~Y , iq66 .~nd ~ rosid~ n Ronte 4 Hox 1l~7~
(Strost and Nurt?bsr)
RORT ~IERCl, SAINT LUCIE COUNTY, lLORIDA
and this :tatsment i: to be tak~n a: my deciaration of dtiunship, actual Ipal rKidena ~nd domicil~ in the Stst~ of Horida.
pnsen hero any pe~tinent facf:, such as ~le of prop~ry or busin~ss, or nlinqui=hm~nt of ~mploym~nt
at former domicile, romoval of family to new domidle, purchas~ of hom~, ~tc.? ~
' ' ' ` FI~EO AND RFCOROEp
Ha~eatead pnrposea-- ST• ~UCIE COUNTY. F~q.
R~CORD VERIFIED _
~l M~R 1s~~
~y P~ 2 : 16
r: oct ~
Y~o~c,tc~--
CLERK CIRCUIT COURT
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i 1 FURTHER CERTIFY that i wili oomplY with all othsr requiroments of a lepal r~ident of this State.
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1 FURTHER CERTIFY tfiat I have no intention to retum to my former domicjle, and i intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. .
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r. $wo~i-3~or'ai1'd'subsuibed befa'e me this ,~~t~h-.i day of 1~[are}- , 19~_.
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; ~ ROaER ,MOITRAt .
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gy D.C. My C.ommission expiros
Re b~ ~oacti~ad iw drpNcaa a~ ori~inal Ai~d wi* CM~i~ qrarft Cw~~, aad d~plkaN wiN~ T~oc Aws~aa .
~ ~165 ~ . 88
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