HomeMy WebLinkAbout2944 _ _ _ .
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D~tuatlon of Domktll! and Citizl~ship
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TO THE STATE ANO COUNTY TAX ASSESSOR, ~
Sl. lUC1E COUNTY, FlOR10A:
This is my declantion of Oomicil~ and Citibnship in th~ Staa of Florkla that 1 am filinq fhf: d~y in aooordana snd
in aonformity with Chaptet 222. Ssction 222.17. Florlda Shtut~s.
I wsi formsrly a Ipal resid~?t of slill Mater NeM Je~ seT
• _ ~Ci~y) (St~tr)
snd I rsstded at p-A-A~: 7~ ~ ~ - Mow~vK I haw chan~d my domkif~
, (Stn~f snd Number)
ro and am and hav~ been a bo+~a fide rosid~nt of th~ Stat~ of Hotida sina ZStI~~ day of
Octobes ~9 67 , and I re.td. ar 176 Liberty Ma~
~t and NumbK)
~ORT rIQCE, SAINT LtlCti COUNTY, RORIDA .
and this statement is b be taken as my deda~ation of ciNunship, actual ipal resid~na and domidl~ in the St~t~ of Hor1d~.
(Inse~t hsn any pertine~t fact:. such as sal~ of propsrty or businsu, or nlinquiihm~nt of ernpioym~nt ~
at former domicil~, romoval of family to ~w domidle, purcha~ of fwme. ~tc.)
~tsblishing residence ~
F11.E0 AN ~OUNlY
~F A~
57. LUC~E ^ .~rR1~t, lE[1
`~~`~~Q~~ ~~4'74
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'fi1 s~4U 6 ~ 9 '
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;;~~;:-r. ~ JiY cou
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~LERK CIRCU
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~ i RJRTHER CHtTiFY that 1 will aomply with all othu nquir~r~ts of a Ipsl rostdsnt of this Staie.
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1 FURTHER CERTIFY that 1_ have-rw intention to retum to my former domic}le, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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1~~n~1~ and wbscr~bed beforo n?e ~is 6th ~y ~ Nove~ber _ 19 6~
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ROOER rO1TtAt .
CIRCWf COY~T - Natary Publk .
gy °~-~~-L' D.C. My Commisslon expirat t
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. b..ao.cw.a M .ml w.d wiei~ a.rlc ci~a~ ce~, t~ wll~ Taoc /1...«e.a
R duplie~N eri~iwal fil~
~168 ~
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