HomeMy WebLinkAbout0193 . ~ ~luation o~ Dofnlail~ a~d Citis~nship .
S3sp3 . .
~ TO THE STATE ANO COUNTY TAX AS.SESSOR. ~ ~
Sl. LUCIE ~OUNTY. FLORIDA: .
This is my decla~etion of Oomicile and Citii~nship in th~ St~ro of Norida th~f 1 am filin~ thit day in aooordana ~nd
in conformity with Chaptsr 222. Section ~22.17, Florida Statu/~s.
I w,s formerly a Ieyal mi~nt of oi a Beaoh Virginia
- - Kih) (St~t~) r
end 1 resided at lu09 Delco Road . How~ver 1 hav~ charq~d my domWl~
. (SnNt s~d NunrtbK)
to and am a~d hsve been a bona fid~ ~~sid~nt of th~ Stst~ of Florida sinos ~d ~Y ~
Septen?ber , 19 ~.•nd I nsid~ a~ 212 Sonthern ~venu~
(Str~t and NumbK)
fORT M~Cf, ~AN~IT LUCIE COUNTY. fLOkiDA
,
and this statement is to bs taken as my d~daratbn of dtirsnship, actusl Ipal ~estdena a~d domidl~ in tht Stat~ of Horida.
pnsert here any psrtinsnt facts, :uch as sals of propKty or bu:ineu, or rolinqui~ment of ~mploym~nt
et former domicile, nmoval of fsmily to Mw domidle, purd~as~ of home, ~tc.) _ ~
Haneats~d purposea
' FIIED AND RECQRO~D~' ~ ~
ST. LUCIE COUNTY, ~q; ;
r~~C ioJrv~3R~Eo
3
. . . '~l I~R I S AN 10 : 09
- fi0^vE= a ~ ~c~~, _
~ _
" CLERK CIRCUlT COURT
~
f
; -
~ .
1 FURTHER CfRTiFY that I will aomply with all o~t?K nquinmsntt of a lepal rssldsnt of tfiis Sht~.
I FURTHER CERTIFY that I hsve no intention to retum to my forme~ domicjle, and 1 intend to remain in FORT
PIERCE, SAlNT LUCIE COUNTY, FIORIDA, permanently.
s_
((daf11R) ~ 1L81 • ~6II
~ ~ ~
.
~dfQ~f~ :~1~ ` ~ ~
J ~
S.
~ J ~
. ~ r • V~~ i~I
~ Q i ~ i ~ ~
t ~ i
• , r`~~
Sworn to and wbscribed before me this day of --.~-.t-
~-s--~,~ :
' ' v • -
S ~ S i ~ ~
~
L~ r ~ ir :
.
- ~vc
ROaER rO1TRAS ' • •
•
Q~ERIC CIRCUR COURT ~ ary Publk
8y D.C. My Commissi~ -
MY ~011MISSION EXPIRES JAN. 23. 1971
. ~ {pNp[D INRY MATlIAR4JO~lO~Md ~ - -
~
R. b. ~ i~ a~piie.~..n~ e~l A~t wi~ u«I~ ci~a~ c.~er, ana a~. wh~ Tax A.....e.a
d00K ~65 ~~E Z92
& _ - - - - w~