HomeMy WebLinkAbout0659 Oeclaration ot Oon~~cil~ and Citis~nsl~lp
1`7363~
TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. IUCiE GOUNTY, FLORIOA:
This is my dsclaration of Oomicile and Citizenship in ths St~te of Florida that 1 am filinq this day in aooo~danoe and
in oonlormity with CMptsr 222. Ssction 222.17, Florida Statutes.
1 wai formsrly e Ipal resident of Buf f alo New Hork
(City) (St~h)
~t 67 ListOn Road my
(Sneef and Number)
to a~d am and hsve baen a bons fide rosident of the Sta» of Florida sinoe 12th
September 68 3222 Oleander AYe.
, 19 , and I roside at
(Sheet snd Numbe~)
!'ORT MQ~. S~AINT LtIC1E COtlNITY, ROR~A
and this statement is to be taken as my dedaration of citizsnship, actual leqal residenoe a~d domicile in the State of Florids. .
pnsert hero a~y pertinent facta, sud~ as sale of property or business, or relinqui~ment of employmant
at formsr domicile, removal of family to new domicite, purchase of Fwrr~e, etc.)
Establishing residence and applyin~ for homestead
~ fIl.EO AND REGORO 0! ~
ST: LUCIE COUNI`Y.
R~CORD VERIFtEO
:~.~a~cJ
~69 JAN e PM I: 9Z
, ~
~ ROGER POITRAS ~
~ CLERK CIRCUIT COURT~
~ _
~
I FURTHER ~HtTIFlf tfiat I wlll oomply wtth all othsr nqui~~ of s Ipal res~dsnt of thls Stata
I FURTHER CHtTIFY that I heve no intention b retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SJUNT WGE COUNTY, FLORIDA, permanently.
```ti
~1ti';- :...tt,!/i.,i,i• Q/ l-!~/ v " '~s' -`r
,:;-,;'.ti~.~ • :~G'~.~-
~ . . r-. : .p ; (Name)
Sarah Lombardo
-'j J~. ~ •S/~?_~•:-: ~
• `.~y.. - -'.5~~~~~~
H
cn t . . . ~
~ ~
' • ~ Q ~
• . - ? tAddr~u)
. . ' . ~ ~b :
•
'.'nI•~.•. yv.s i`~~
Swa~'io and wbKribed befor~ n+. this Sth d,y Tanuary , tq69 .
. +
ROOlt fORRAf
CRCwT~ C~1lT~' ~ Notary Publk
i.l.~ic/
- 8y D.C. My ~orr+mission expins
R. r. «»a~l~i i~ i~Ncal..~i nl~i wMi~ aMlc d~aiil c.wr. .w~ ~~rMi~ T.o~ A...w.a
~O~OK ~A6f
ti.. _ . _ _ . .
- _ , z G . _ ~
~ 5a _ <
_ ~''~s~.`~~.~-s~s~-.:-..~',~,~nr, -