HomeMy WebLinkAbout2049 Declaratio~ ot Domfcife and Citizenship 166`?'64
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA: ~
This is my detlaration of Oomicile and Citizenship in the State of Florida that I am filing thi: day in atoordante a~d
in conformity with Chapter 222, Section 2~2.17, Florida Statutes.
I was formerly a legal ~esident of - NCM Yort Ne~r YorY
(Ciy) (State)
and I resided at 83-SS AUSt~D St. Yew G~idetlS _ Fiowever I have changed my domic,ile
. (Street and Number)
to and am and have been a bona fide resident of the State of Flotida since 8tb day of
April ,~9
6~, and I reside at 820 AiroSO Blvd. POrt St. T•uCie
(Street and Number)
~O!!~, SAINT LUCIE COUNTY, RORI~A
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
~ y'~1•f ~ < -
Bstablishing residence
Ftl.Ep AND RECOROEb~,_
ST. LUCIE COUNTY. RLA.
~1~?b-lO?~~Ft~~
'68 9 : S 1
.~~uJ
i~OGE~ POiTRAS
CLERK CIRCU~T COURT-
1 FURTHER CERTIFY that I will oomply with all other requi~emenb of a le~al resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former o icile, and to remain in FORT
?IERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
a'~+l.Lal
(Name) LOLllB Bl~rYaOA
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.
' 'i•J
`~:~}°=••'~P.•:~~ g
0 ~iroso~vc~. Port St. Lucie
. • - ~ = F~OZ~ds
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_ Sw~n: `and suburibed before me this 3rd day of - ~q , 19 68
.
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,
. ~
~ . ~ ~i~ ~OITRAS
' CIRCUIT C Notary Public
6Y D.C. My Commiuion expins
R~ b~ .~a~i i~ d~iiea~. aAd ori~iwal lilad wid~ CI~.k Cira~it Ca~e+, aed d~plieaN wi11~ Tax 11~.a
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