HomeMy WebLinkAbout2259 O~luatton o~ Do~lail~ a~d CINs~iP
TO THE STATE AND COIJNTY TAX ASSESSOR,
Sl. UJCIE COUNTY. FIORiCl1: -
This is my d~dantion of Oomial~ a~d Cftiz~nship i~ th~ St~» of Horida that 1 a~+ filtn~ this day i~ aooorda~a ~d
in conformily with ChaptK 2Z4. Sation 224.17, Florida Statuhs. .
1 was for~r~ly a Ipal roticl~nt of .
l~CitY) 1~~)
q/ 7dt
and k ruid~d at ~+V ~ " . Fiovwv~ 1 h~w chan~d nry domk3l~
(Strert a~d Numk~r) ~
to ~nd am ~~d haw bs~n a bona fide r~sidsnt of the State of Florida sinos dy? of
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, 14 , and 1 rosid~ st ~ a'`'`'~
. (ShNt ar~d Numbsr) '
NDRT ~i~Gl. tAMIT LtIC1E COtN~IiY. lL~ORpA
and this sts~Mn~t 1s to be taken a: my deciaration of dtiienship, actual lepsl rosideno~ and domidie in ths Stet~ of Horid~.
q~aart hen any pertineM fads, wch as sale of property or bud~ss, or rolinquishmsnt of ~n?ploy~nwnt
at formK domidle, removal of family to ~ew domidle, purchase af home, etc.)
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; FIIED AND RECOflOED
~ • ST. LUCI~ COUNTY, FLA.
~ RiC~~FiED
'68 SEP 3o ANI 9:0T
ROGER POITRAS
i Fv~ ar~~~4 ~~i4~~4~ .~i a~.~ ~~~n ~ . ~ ~w«n ~ s~.~..
1 fURTHER CERTIFY that 1 haw no intention b rotum to my formsr domkile, and 1 intend to romain in FOKT
PIERCE. SAINT WGIE COUWTY. RORIDA, psrmansntly
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Sworn b~nd subsctib~d b~foh m~ thb dh? . 19 .
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