HomeMy WebLinkAbout0492 ~
Decia~atlo~ ot Dornlcll• and Citisenship .C~1~s
. ,
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. lUC1E ~OUNTY. FIQRIDA: ~
This is my :cla~ation of Oomicile and Citizenship in the State of Florida that 1 am filing this day in accordanoe and
~n confo~mity with Chapte~ 222, Section 2Z2.17, Florida Statutes.
I was formerly a(egal ~esident of $88t EBVeri y0Y1II. _
(City) (Stats)
and I resided at ~ 19 S81t@A8t811 . Flcwever t have chanqed my domivle
(Street and Number)
to and am and have been a bona fide resident of the State af florida sinte 17th day of
------~c~vombor , t9~, and 1 roside ar __1610 Bnaton Ave. ~
(Street and Number)
FORT PIERCE, S/11NT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citi:enship, actual legal re:idence and domicile in the State of Florida.
. ;
(Inse~t here any pe~tinent 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.)
~ntering Hi.chelie in the _3rd grade
( ~ynch ) ,
FILEO AND RECORDEO~ _ ~
ST.RECORO VERIFIEO~~
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N 2:12 i~i856 !
'6T NOV 20 P ~ ~ ;
ip~~:R POITRAS
CLERK CIRCUIT COUR7 '
i FURTHER G'ERTIFY fhat 1 wilt pmply with all other requirementa of a le~al rasident of this Stale. '
I FURTHER CERTIFY that 1 have no intention to return to my former domiSile, and I intend to remain in fORT
?IERCE, SAII~~.UJCIE COUNTY, FLORIDA, permar~ently.
s.~,..t~J..
~i~~~ . .
I~
' ~ " ~ . . ~ ~ ~ ~yame)
Arlene 7,eeneski ( Yra Frank )
" ~ " ' =
_l~
~ / ~ Wddress)
. C~~ :
S~+orn to end subscribed be#ore me this 20thday of aovember ~ 19 6'j ~
~
ROGER PORRAS ~
,
CIRCUR COURT Notary Public t
sY D.C. My Commission expires
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Ro b~ ~x~culad in duplicaN and oei~n~l fibd witb Cl~ek qra~if Court, and duplicst~ wieh Tax Aswsror.j
a~K~69 ~ 48?.
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