HomeMy WebLinkAbout2822 ~ ~ 163332 ~
Declaratio~ ot Dornicii• aed Cftlse~shlp
~
TrJ THE STATE AND ~OUNTY TAX ASSESSOR, :
Sl. lUC1E COUNTY, FLORIDA: '
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This is my declaration of Oomicile and Citizen:hip in the State of florida that I am fili~p this day In acao~danos and ~
in conformity with Chapte? ?24, Settio~ 2??,17, florida Statutes. ~
I was formerly a legal resident of Dover A~kgnBge ~
(Ciy) ;Sta») ~
Rt. 1 ~
and t msided at ~ _ However 1 huve chanped my domiCile
(Street and Number)
to and am and have been a bona fide ~eside~t of the State of Florids sinoe 5~ day of
~
_ Jsnuar~__ ~_19 68 , and I reside at Bevel~ly YoDile Home PaY'k :
(Stteet and Number)
FORT PIERC~, SAINT lUC1E COUNtY, RORIDA -
and this statement it to be taken as my declarotion of citizenship, actual legal residence and domicile in the Staro of Horida.
(Insert here any pertine~t facts, such as sale of property or busineu, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase of hane, etc.)
Teresa Jo
~ Paula Annette F1LE0 ~t10 R ^ORDED
S~. LUCIt ~~UNTY. FL:..
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163?332
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_r... ~.,t?till" (;iUriT
1 FURTHER CEitTIFY that I will oomply with all othe~ requiremenfs of a legal resident of this State. '
I FURTHER CERTlFY that 1 have no intention to retum to my forme~ domicjle, and I i~tend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, fIORIDA, permanently.
_~1...~. '
(Name) -
- Paul Cwabie
, • (Address)
i•,V , : y ;~,r' , ` .
-Sw~n ~o,~d~ibscribed before me this 8th day of da11ua2'v ~q~_.
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. - N ' y~QG~; ~~QR~A~ ,
' CIKCU ~COURT
~ ^ ~ , Notary Public
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BY , ~ D.C. My Commiuion expires
(To b~ ~x~cvNd in duplleata ind oei~inal fil~d wilb Cl~rlc Cinarif Cowt, and dupKcaf~ wiN~ Tax As~or.) .
~~6~9 ~28G3- r _