HomeMy WebLinkAbout0258 :l`7i5i'7
D~alaratlon ot Domlall~ and Citis~nshlp
TO THE STATE AND COtJNTY TAX ASSESSOR,
Sl. tIJCtE COUNTY, FWRIDA:
This is my deduation of Domicile and Citi~snship i~ ths 5tate of Florida that 1 am filirp thls day in aooordano~ ~+d
in conformity with Chapter 2Z2, Ssction Z22.17, Florida Stahita.
1 wa: formsrlr a Ipal nsid~nt of ~aBtoaia 1~. C.
(City) (Sta»)
and ~ ros~dsd at 145 111n8et Cirole my ~~N
(Stroet and NumbK)
to and am and have been a bona Hd~ rosident of the Stste of Ncrid~ sinoe Oet. 1Q' ~y ~
,~9_bH., and ~~s~de a~ ?21 Sonth 2nd 8treet, Apt. 2
(Street snd Numb~r) `
l~ORT MER~, SAINT LUCIE COUNTY, ROR~A
snd this statbment is tn be taken as my dsclarotion of citi~snship, ectual lepal res'idenos and domidle in the State af Horida.
(
pnsert hero any pertinent facts, such as sale of property or busine:s, or relinquishment of emplayma~t
at formr: domicile, r+emoval of family to new domiale, purchsse of home, etc.)
Placing children in pnblia eahool$ - Bobb~ & Donglae
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'68 OCT 22 PM !2: 56
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! ~~~,~R e 01'fRAS
i ~~ERK ~IR~UI~ COUR7 -
1 FURTHER C~RTIFY tf~st I will aomply with al) othsr requirerrwnh ot a Ipal residsnt of thb State.
I FURTHER CERTIFY that I have no intention to retum to my former domivle, a~ I intend to remain in FOltT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(A~ddres:)
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~ ~ ~ . : 22nd October 68
S~worn~~p ~td wbscribed before ms this day of , 19 .
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Ct~IC GRCiNT COI~RT Notary Publk
8~? D.C. My Commis=ion ~xpires
Re b~ ~cdNd ia dupWesl~ and o~iaiwal fil~d wi1M CMrt Ci~a~it Cw~t, and d~pliat~ wi~ Tax A~ora
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