HomeMy WebLinkAbout2800 . 1'~i18S
o.aluaNon o! oo~nit~i~~ ~tnd Ctt~.nship
TO THE STAT~ AND COUNTY TAX ASS65SOR,
Sl. UJCIE G~tJNTY, FIORICII: -
Thit b my d~cl~~atwn of Oomidl~ ~nd Citi~nship in ths Stat~ of Florida that 1 am filirp thit day in aooordano~ ~nd
i~ aonformity wlth ChaptK 222, Ssttion 2Z~.1~, Rorida Statuf~s.
COl'II~II$ BAR ?~2'Y '
1 was formKly a Ipal resid~nt of
(G1Y) - fSb1~)
and ~~td.d at 150 w. Pnl'~eg4f Street _ How~.wr ~ hav~ chsnp~d my domtdl~ ~
(Sfn~t and NwrbK)
t~o and am a~d have b~ a bona fide r~id~t of th~ Stat~ oi Florida si~a OCt. 4 cla~r of
19~. n 8onte 4, Boz 644 ,
(Str.~t and Nwt+ba)
lORT MQC~, fANT LNq! COUNT~, I~LiORqA
and this stat~rt»nt is ro be take~ as my dedsration of atiunshtp, actual lepai residsnos and domicil~ in fht Stst~ af ~lotlda.
pnsert hero s~y pertine~t fads, such as aale of propsrty or busin~ss, or relinc~ishm~t~of ~mplo~t
at forn+K domicil~, ~rw~ral of funily to new domkil~. Purchass of honk. N~cJ
Entering children in pablia eohool~' =~~qnQa, ' 3heri ~td Lori ~
~IIE~ ANO RECOROED ~ -
- ST. LUCIE COUNYY, ~LA.
F?F.COR~ VERIFfED
1'71185
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. ~seocTi~~~:22
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; ~ RO~ER ~0{7RAS
CLERK CIRCUIT COURT
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E .
I FURTHER CfR11FY tlwt i wiil aomply with ill otl~r nquinm~nb of a Ipal raid~t af this Statt.
1 FURTHER CERTIFY thst 1 hav~e no iMention ta rMum to my fomner domicile, snd I intend to rem~in in FORT
WERCE, 5111NT WCIE COUNTY, FLORIDA, permaner~tly.
.
p~~ oan 4ravia
U1~dd?eu)
~ y~ ~ ~ ~ ~ llth ~ ~ Ootober 19 68
ROpi1t ~d~RA~ .
H~ iOtM~' Notary Pu~blk
~r D
C. My Con+mission ~ocpina
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