HomeMy WebLinkAbout2283 D~cl~ration ot Domicif~ and Citis~nship
1'~~:'?"?'S `
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. LUCtE COUNTY. FIORIDA:
Thts i: my decla~ation of Ooenidte a~d Citizenship in ths State of Horida that 1 am filirp thi: dey in aooadanos ~nd
in oonformiy with Chapter 22?, Ssction 22Z.17, Florida Statutes.
I was formerly a leqal rosident of Minneanolis ~ Minn.
(City) (Stah)
and 1 rosided at 3112 Lonqf ellow Ave. So. . However 1 h~ve d~sn~sd my domWle
(Streef and Number)
to and sm and have been a bona fide resident of the Stste of Florida ainoe 15th day of
Februar~? , 19 6?, and I reside at 3724 Irnqunis Ave~
(5treet and Number)
l~ORT M~ SAINT LUCIE COUNTY, RORIDA
snd this statament is to be taken as my dacla~ation of citizenship, a~~~sl legal residenoe and domidle in the State of Horida.
pnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family b new domicile, purchsse of home, etc.)
Fi~~o aNO RECOROEO'.
ST. LUCIE COUNTY. FLA.
RE:,CLOR'~D~S EO
~se oEC 9 a~ ~ 5
~ . y~ ~
! ROGE~OITRAS ~
CLERK CIRCUIT COUR7~
l
i FUitTHER GHtTIFY that 1 will comply with all other ~equirem~nt= of a leyal rasident of this State.
1 FURTHER CERTIFY thst I have no intention to retum to my former domic,ile, and 1 intend to remain in FORT
PIEi~E, SAINT ~~-.COUNTY, FLORIDA, permanently.
. :
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_ i ; ~ : ~~;''f:;;, : . IAUI S C . NESS ~ ~ . -
, ~
_ . ,
- . (Name)
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~ - J ~ ? ~ - 3724 Iroquois Ave. ,Ft. Pierce , Fla.
. , .
• ' . •j: ~ ^ ' (~4ddress)
-
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Sworn to snd subscribed before me this 9th day of December ~q 68,
ROG~ rORRAS
CL~RK CIRCIlIT COURT Notary Public
~
8y ~ D.C. My Gommiuion expires
~
i
lTo b~ ~x~wNd in d~rpNcah and ori~inai A{~d whb Cl~ek Ci~ Couet, and duplicN~ wi11~ Tax A~~ora
~~~74 ~2~"~'8
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