HomeMy WebLinkAbout1220 . 1'~'0180
D~claratio~ ot Domlall~ and CittsMShip
TO TIiE STATE AND COUNTY TAX ASSESSOR,
St. U1CIE COUNTY, FLORIDA:
This is my dxlantion of Oomicile and Citiz~nship i~ th~ Stats of Florida that 1 am filin~ this day in aooon~ana ~nd
i~ aontormiy with Chapter 2Y2, Ssttion 222.17, Rorida Statut~s.
1 was iormerly a Ipsl rosidsnt af PO rt Chc 3t e t A1- Y.
(City)
. •r 370 Westchester Avenut .~,.r ~ haw d,~ns,~ed R,y don,tdl.
~t a~+d Numbe~)
to and am and haw been a bons fide r~ident of the Staro of Fiorida sinoe June 20 ~y ~
, 19~$_, and I r~ide at 108 Rioaar Court - Por.
t~
t=L~cie
(Stro~t and Numbsr)
EORT M~, SAINT LtIC~ COUI~ITY, RORIDA
and this ttaMment is to be taken as my deda~ation of citizenship, actualleQal residenoe. and domkile in th~ State of Horid~.
qnsert here any pertinent fscts, such as sale of property or business, or relinqui~ment of employment
at fiormer domldle, removal of family ro new domicile, purchase of home, etc.)
Bstablishing residence
_ '
- va
~
~ ~ ~
H •
x~ ~ n~~
n
~ ~
A~
~ ~ CO ~
' --1-i
I ~ O D aD
~ -
~
~ -
~ .
~
! .
~ N
1 FURTHER CiRTIFY ihat I wili oomply wHfi all othsr requiromer~t= of a le~al resident of thb State.
~ I FURTt1ER CERTIFY that I have no intention to retum to my former domicjle, and I intend to ~emain in FORT
PIHtCE, SAINT LUCfE COUNTY, FLORIDA, permanentiy.
. '
.
~ ; ~ Jennie M. Ceru i ~ ~
~ . :t•r~ w
<
~ ~ _ - . • . . ~V` ,;~ii_ .
- _ " U1~dclress)
=4
~'t S~on%.fb~ arid~tubscribsd before me this Stb ~y SCDt ember , 19 6$.
:
C' .
~
CtiRl( CIRtXltT COURT Notary Public
By D.C. My Commission ~xpins
R~ w.ar~cw.d- iw d~plieata aed o~wal fii.d wNb CI«k Ci~erM cew~, .nd d~pticaN wi1M Tau A.....ora
~ 800ic ~ ~ F~~
~s -