HomeMy WebLinkAbout0129 ~Decl~uratton 4t Do~nlcll~ an~ Gitizsnship i61f
08
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TO THE STATE ANO COUNTY TAX ASSESSQR, ~
Si . IUCIE COUNTY, FLORIDA: t
This is my de~la~Ation of Uomicile a~c! Gitisenship in the State of Florida that 1 am fitiny this day in aooord~na and
~n aonformity with Cfiapter 222, Section 222.17, Horida Statutes.
1 was formerly a legal resident of Oolu~bn/ ~ Oh10 ~
(City) (Stah) ~
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and 1 resided at _ 145~ GreQ~~~ 8oad . Howevsr 1 have cha~e~ed my domidle I
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- (Street and Number) _ ~
to and am ar~d have been a bons fide rosid~nt of the State of Flo~ida sinoe 3a~ dsy of
OQtobe~. , 19-~ and 1,e:ide at _~.~?RS..-Sr~t~ ATlL- .
(Stteet and Number) ~
FORT PIERCE, SAlNT LUCIE COUNTY, RORIDA ~
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and this statemar.t is to be taken as my declaration of citizenship, actuat legal residence snd domidle in the Stats of florida. '
(Inse~t here any pertinant facts, such as sals of property or business, or relinquishment of ennployment 4
at former domicile, removal of family to new domicile, purchase of home, etc.)
Sntering 8ob~rt B in the lot grad•
( Yeado~s ) ~
" Zinda Anguaih in ths 9th ~caa~ gT~~U~ E ~ vECORp~p• ~
REC~RD YERIFIEp '
~ I.arr~ Jingusih in ths 12th grsd. lsi~$
~T Npy 9 pN j . ~i ~,~~i
R ~P/,~~K~
- CL.ERK CIRCU j TRAS
T COURT
I _
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1 FURTHER ~ERTIFY that 1 will aomply with all ofher requirement~ of a lepal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in fORT
NIERCE, SAINT LUCIE COUNTIf, FLORIDA, permanently.
1~~.ti~ ~~~:~~~'~Ir ~
t: L ~4_ r~, .
J •iZi1 % ~ ei. ~
• !•~~y~ ~ 7
- . ; cG~~ : r (Name) ,
_ ~ene C• Y~a~os~ ~
" - ~ ~
`-l ~ ';:'l ~~L;Jii. ~ . _ c
i
• : - ltorma Z. ~ea~~w• '
~ •,~t.L,r~..:L~. 1
.
Sworn to and suburibed befors me this 9th day of ~O~~b~r 19~. '
~ ROG~ rORRAS . -
CIRCUIT COURT Notsry Public
gy °L~`'~ ~~~J D.C. My ~ommissiwn expiras ~
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(To b~ ~ocwevlad in duplicaN and ariginal fil~! wiN~ Cls~lc ~ Caree, and d~plicNs wi1i~ Tax As~ar~
~K P~CE d~.d,7
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