HomeMy WebLinkAbout0464 ~ Citlzenshi 1s1~0
D~ctaratia+n ot Doenlail~ and p
,
TO THE STATE AND COUNTY TAX ASSESSOR,
51 _ UKIE COUNTY, FLORIOA:
This is my declaration of Lbmicile and Citizenship in ths Stats of Florida that 1 am filin~ this day in sooordana and
~n conformiry with Chapter 222, Section 222.17. Florida Statutes.
B~`bDa e Ner YQr~c
1 was formerly a legal ~esident of 8 -
Kity) (Stats)
and I resiaed at _~1~alt~n ~ad Howevar 1 fiave chan~sd my domkile
(Shset and Number)
to and am and have :,een a bona fide resident of the Stats af florida sit~ce Aer: ~ lat day of
_A~*~l , 19-b.?, and I reside at fintrada Avenue, Port St_ L-~c±~
_ - (Street and Numbsr)
FORT PIEftCE, SAINT lUC1E COUNTY, RORIDA
and th~s statement is to be taken as my daclaration of citizenship, actusl legal re:idencs and domidle in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bought house and ~ishes to
Establish residence here.
~ FILED AND RECOROED'
ST, lUC1E COUNTY. ~LA.
RECORD VERtFIED
i '6t NQV ~2~~AM~10 : 37
~
ROGER i'OITRAS
E CIERK CIRCUIT COURT ~
~
1 FURTHER CERTIFY that I will aomply with all other requi~emsr~is of a lepal resident of thls Stste. ~
. ~
I FURTHER CERTIFY that 1 have no intention to retum to my former domicale, and 1 intend to remain in FORT ~
PIERCE, SA1NT LUCIE COUNTY, FLORIOA, permanently.
~
~~z; 3
(Name) Fred Peluso '
3
,
!
!
_
~ (Add~esS)
~
i
Sworn to and subsuibed before me this 20th day of November , ~q 67 t
,
, ~
ROGER-.'O~TRAS
_ Q~RK CIRCUIf COURT Notary Pubiic
gy - D.C. My Commiu'wn expires
- - ,
.
-,_.t-:;-
RR.1~ ~ in dupliuN and oei~in~l fif~d whh Cl~lc qnuh Couei. and duplicae~ ~witb Tax Asta~or.)
g~K 169 ~ 459 `
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