HomeMy WebLinkAbout2377 ~.~.A.~_,
D~claratbn of Domiaii~ and Citi:MSbip 1`7~~'7
TO TiiE STATE /WD COUNTY TAX ASSESSOR,
Si. tUC1E GOUNTY. FLORIDl1:
This is my declaration of Domicil~ and Ctiz~nship i~ ths Staro of Haida that i ~m Nlin~ this day in sooordanc~ ~,d
in oonlormity with Chaptt: 2Z2, Ssttion 222.17, Florida Statuhs.
~ was t«mK~y a ~.Qa~ nsida,r of Buf f alo . ~ NeM Yosk
(Ciqr) _ tSRat~)
and I~idsd at 328 ~eDdtica[s Blvd. ~~w -
ch~rp~d m~r domicjl~
(Stntt and .Numbe~)
to ~nd am and have been a bona fid~ rosideot of ths Stste of Fbrida sino~ - Se~t - 1 day af
, t9 68 , and I r~We at 1V20 Wyoning Ave. -
(Stnst snd Numbe~)
1'O~T l~CE, SAN~IT ~NCIE COtJNTY, RORnA
and this state~r~ent is io bs taken as my dsdaration of dtizanship, actuai iegai residenoe and domkile in ths Ststa o~F F{or~.
q~art here any pertir~ent facrs, such as sek of property or business, or mlinquishmsnt of employmsnt
at formsr domicils, rorrwval of family to new cbmicile, purchase of Fame, etc.)
Placing children in public s~chool - JenLifes & David ~
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~ 1 RJRTHER GfRTIFY that 1 will aompiy with ~il othsr r~quirerr~atts of ~ leyal »sldsnt of this Stab.
1 FUR7HER CERTIFY thst I hsve no intention to retum to my forme~ domkile, and i intsnd to ~emein in FORT
PIERCE, SAINT LUCtE COUMY, FLORIDA, permsnenHy.
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~ ~ ~ ~ ~ (Name) Rid~ ar ~ 1Cayea -
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Sworn b and sub~crib~d b~for~ rrk tfia day of _,_o , 14~
tOOR r0lTRAf
~ Ct~t C~WIT trotar~r Publk
e~r ` O.C. My comn,tuion .xpl~
R~ M~eM~ 1. ~«N1 «i~.t AI~ ~rilU d«it CMaiif Gwt, a~ ~Ma1~ wfll~ Ta~s Aw«.~.,j
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