HomeMy WebLinkAbout2780 1'711'?'2
O~cluatlon ~ Domiail~ and Citi=MSh1p -
TO THE STATE AND COUNTY TAX ASSESSOR.
Sl. LUCIE COUNTY. FLORIDA: •
This is my d~d~ntian of Domicile and Citinanship in th~ State of Horid~ that 1 am fili~p this day in aooordano~ and
in aonforrr~ity with CMptK 222. S~ction 24Z.17. Horid~ Statut~es.
~ i w~, ~~~y ~ ,~~„t ~ HollYr+ood California
(CiN) tStat~)
snd 1~id~d at 1737 No. Mhitlty AvC. Howw~ 1 haw charp~d my domidl~ _
(Stn~t and NumbK) .
b and am and hsw besn a bona fid~ rostd~nt of tM Shts of Harida s~nas ~t ` 1 day of
196$_, and I roside at ~401 Ssn Diego
(She~t and Numbsr)
~ .
!~QlT'FM~CR iA1N? UIC~ tOUNfY. RORlDA
and fhis :hrinMnt is to bs take~ as my dadaration of citinsnship, actual lepal rosidsnw and domkile in the State of Horida.
p~asrt I~e sny psrtinent fach, such as sale of propsrty or business, or relinquishmsnt of emptoyment
~t forrnK domidls. rm+oval of family ro new daniale, purchsse of home, etc-)
Bstabliah legal residence
. F1LEp qNp RE~ORDE~
ST, ~UC~E COUNTY
RFCORp VERtF1E0LA' .
~se o 17'117`2
~ _ Ct ! 0 P~y 3: 5!.
~ c~eRK oirR
C?RCU~T ~p~RT
1 R1RTI~ER CHtTIFY tl~at 1 wlll oomply with all o~ nquir~rrwnts of a Ipsl raident of tfi~ Stst~.
1 FURTHER CERTIFY that 1 hsve no intention to mtum to my former domkile, and I intend to ~emain in FORT
PiERCE, SAINT WCIE COUNTY. FLORIDA, permansntly.
~
~ (Name)~ R• J• waoa
U~dd~
Sw~orn b~nd subsc~ib~ b~for~ n~ tha lOth ~y a{ OCtOber - 19 b8 •
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QMK ~ _ , - Nohry Public
~ ~ . O.C. My CorrNnission sxpin~
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R~ w sMwN~ iw ii~Kcw a~ ~i~~l lll~ wilb CMiI~ CMwM Gw~. aMi ~Ne~ wli Taat A~w~a
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