HomeMy WebLinkAbout1204 D~aluation o! Domiall~ a~d Citiz~nship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~~4
51. lUC1E GOUNTY. FLORIDA:
This is my d~tlaration of Dwni~ile and Citissnship in th~ Stet~ of Horida that 1 am filinq thit day in aooorda~ and
in oonformiry with Chapter 222, Section 222.17, Plorida Stetutes.
1 wa: formariy a le~al rosid~nt of ~n S~ble Fbrks Ne~ ?ol`It
(CHY) (St~t~)
and 1 ~esided at Hat~icep?e bodge : How~v~r 1 h~w ch~n~d my domid~
~ (Sh~et and Number) .
b snd am and have be~n a bona fids resident of th~ Stah of Flotida sino~ ~Y ~
Nov~ember ~ 11li2 Herandot St
, 19 , ~nd 1 roald~ at
~ (Stnet a~d Number)
?~ORT NQC~, SAINT ltIC1E COUNTY. lLORIOA
and this :tatams~t is to be tak~n a: my declaratbn of dti~snship, actuel Ipal rafd~na and domicil~ in fhe Ststt of Horida•
qnsert here any pertinent fads, :uch a: sal~ of propsrty or butin~ss, or relinquithm~nt of erinpioym~nt
st f~mer domicile, ronwvai of fsmily to n~w domicile, purchss~ of Fame, etc.)
~IE3TS~D PU1tPOS83 . '
fILED AND RECORC,~O~,,!
ST, lUC1E COUNTYi FLA• .
RECORtl ~1~R~~~EO
.t542`74 -
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RO~ER POiTR»S
CIERK.CIRCUIT COURT
i
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1
1 RIRTHER CERTIFY that 1 will oomply with all otF~ requin~rNnh of a le~al r~ideM of this Stah.
1 FURTHER CERTIFY that I have no intention to retum to my fomner domidle, and 1 infend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Nams) 14 Hat'~pod
'`,``,;~~~+~!?~~tii~~~f~~~~ . 11l12 Hernando Sti'eet~ P't. Pieres~ Fla•
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~ ~ , v :S~rom. ~G •bsd before me this ~7~ day of Ziarcb 6T -
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~ Wot~ry Pubik
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By D.C. My Commission ~xpi~
R. b. .~o.w»~ ia a~uWr. sai «i~w.~ A~.a a,i~ a.ek ci~h c.w~, .wa a~p~a~. a?i~ T.oc A....~e.a =
~ a~~~ 65 ~1201'
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