HomeMy WebLinkAbout2804 ~ aa~a~at~on et ~omicN~ a~d C~~nsh~p 15'~'450
TO THE ST/1TE ANO COUNTY TAX ASSESSOR, ~ -
51. U1ClE COUNTY. FIORIDA: ~
Thts is my declantion of Oanicile and Gitizenship i~ th~ State of Horida that I ~m filinq thi= day i~ acoordano~ a~d
in aonformity with Chapter 224. Section 222.17, Florida Statuhs. -
i was (ormarly a ipal rosld.~t of ~rryaviilt Penn
(GtY) (Stais)
•r,d i rss~dsd at 3266 B~erRreen Dri~~ . HowevK 1 haw chanq~cLmy domTdN
. . (Str~t e~nd Numbsr)
b and am snd haw be~n a bona fids msid~nt of the Stsb of Florid~ sinos 2ath day of
llarcb , 19 67 , a~ i~~ ~ ?77 L~sas Street
(Stre~t and Number)
fORT iA1NT LNCIE COUNTY, RO~IDA -
and thi: statement i: ro be teken a: my deciaration of citizenship, actual IeQai raidence and domicile in the Stat~ of Horida.
pnsert here any pertinent facts, such ss sale of property or business, or rolinqui=hmsnt of ~mployrnMt
-af forrt~ domidis, removal of family to new domkile, purchase of Fame, etc.) • ~
Sstablisbing residence - -
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~ FIl.EO AN .
sT. WCI! COU1?
TY,~~~ € _
RECORD YERIFIE~'
. ~l JUN 21 ~S~'~50
~ ~ : 28
' RO~ER ~'OITR
' ~LERK CIRCUIT C
URT
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~ aJan~Ea c~anFlr thst ~ wiu oomply with s~~ otF~ n.qutrems~,ts of e ~e~.~ reslde~t of thf: stste.
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I FURTHER CERTIFY that I have no intention to rotum to my former domivle, and ! iMend to remain in FORT ~
_ ;
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently. ~
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= ~ --~>:°=}a~ - ~ 2Ttb day ~ June 6T
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~ ~pn~l'~wbsvibsd before me this 19 . ;
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p~ ~ Notsry Pubik ~
gr O.C. My Commiuion ~xpiras
a. b..x~a»~I ~~pli~.~. .wa o~e~r Rl.a a.~k ciew~ir coue+, .pa d~paW+. u?i~ T.x A......ra
~ a~~i66 ~2802
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