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HomeMy WebLinkAbout1578 ~ D~cluatlon ot DomIc11~ and Cttis~nshlp ~ 154531 TO THE STATE AND GOUNTY TAX A?SSESSOR, Sl. IUCIE COUNTY, FtORIDA: This is my decls~ation of Oomicile and Citisenship In th~ Stat~ of Horida that 1 am fili~p this day i~ aooordano~ and in conformity with ChaptK 222. Sation 222.17, Florida Statutss. 1 was formerly a leqel msid~nt of S t.Lo u i a l~le ~qty~ (Stab) and 1 rosided at 5576 Pershint~ Blvd ~ . Howewr I haw d~anq~al my danWl~ . (StrMt and Numbar) ro end am and have been a bona fide reiidsnt of the Stsro of Horids :inoe 27th ~y ~ March , ~q 67, a~ ~ n 601 So Ocean Drive- Se ~b (StnN snd Numbsr) FORT N~C~, SAINT LUCIE COUNTY, RORIDA . and this statement is to be tek~n a: my dedaration of citiu~ship, actual le~al resiclena and domidl~ in ths Stste of Florida. qnsert here any pertinent facts, such as sale of property or busines:, or relinqui:hn?e~t of smploym~t+t at fomner domidle, romoval of fsmily ro new domicile, purchsse of hane, ~tc.) Bstablishing residence - $ntering Rafael A. Him in High school, who is in the care of Jerry Hogue ~ILED E CpUN?YDFI.A: ST. LUC R~CCRD VER{FIED ~ 154531 '61 APR q . ~ ' 03 - k iiAO~~I~ . • n•~:'l; s•l~}~~R.~.cJ » v ~~,ERK CIRCUIT COURT - I RJRTHER CHtTIFY fhat I will oomply with all othsr requi~ement: of a le~al r~Idenf of this Stete. . 1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. , ~~>>`t ~ ~ ` 11 NC f'i, . ; Q, ~ ~ '~O''~, 'y ' : y~ i c+G.,.~` . (Name) v.~:~.,.~..~~j; jt ~ , , - G:;. = Jerry Nogue _ . - - _ {p ~ ' • ~ : t!? ' ' = _ +~r ' . - .1_r'~ie~`~~`~ : ~ . - ..-,,,,,F,,,,' ' ~ _ (Address) ~ > !r,^, w - ~•,..,.,.:,-~~~~G~"'~~ 4th April q 6? Sworn to snd wbscribed befom me this day of 1 ROGL~R ~ORRAS . ~ Cp~T Notary Pubfk. By «-t-~~i ~ 0.~. My Commission expiros - lT~ b~ ~oacrhd iw dvpNcM~ sa~l o~iab~l fN~d wili~ Cl~ek Cinarit Gw~, a~d d~piiaN vvi~ T~ac Asw~o~a eoou~~J ~~~J~~ ~ ~~.h~ _ ~ ~ ~ s' . . +i ~