HomeMy WebLinkAbout0750 i
Oecla~atlo~ o! Oomicile and Cttize~ship `
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TO THE STATE AND GOUNTY TAX ASSESSOR, ~
ST. lUC1E COUNTY. FlOR10A:
Thi: ii my decla~ation of Domicils a~d Citiunship in th~ St~t~ of Florida that 1 am filinp this day in aooordana and ~
in oonfo~mity with Chapte~ 222, Ssction 244.17, ~lorida Staluta. #
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1 was formeriy a Ipal rosident o~len B119D I11 ~
(City) (Stat~) ~
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snd 1 resided at 1153 Lundonberrv Lane Fbw~vK I haw cha~pscl my domkil~ ~
(Street and Numbe~)
to and am and have been a bona fide miident of th~ State of Florida sinas 2~d d~y ~ '
;
October g Flornaine Hotel- No_ U.3_ ~ 1
, 196 , and I reside at '
(Street ~nd Num~) ;
FORT PIERCE, SAINT LUC[E COUNTY, RORIDA
snd thi: statement i: ro be take~ as my dedaration of dtizen~ip, actual Ispai residenos and domkil~ in the Sta» of Horid~. `
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(Insert here any pertinent facti, wch as sa{e of propsrty or business, or mli~qvi:hrn~nt of ~niploym~nt
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st former domicile, romoval of family to new domicile, purcha~ of hoa~e, Nt.) ~
Bstablishing residence ~
.~-'~'S`?"~'4
FILED AN~ RECORD~D
_ - Si. LUCIE COUNTY. FLQ~.
E3~_~~R~ V=_RIFIED
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'69 MAR t 8 PM 2: I 1~~~~
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~ ~OGE?~ FO1TR6,S _
! C~ERK CIRCUIT COURT
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1 RJRTHER GERTIFlf that I wili oomply with all ath~r requits~rwnts of a lepai ~~ident of this St~f~e.
1 FURTHER CERTIFY that I have no intention to retum to my former domic~le, s~d I i~tsnd to remsin in FORT
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
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~,`~;~;;:t~r,~.y: . i'
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~ • _ ' ' ' ~ Gloria Ann Yurusis ( Mrs Nicholaa
~ J-- ' . .~t ~
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" _ „ c. _q ~
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N ' - (Adclfesi)
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~ ~ ! S,~ivalin ~~~d=iubsuibsd before me this 18th ~y ~ FebtusLy ~ , 19~
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ROGER POITRAS
CIRCUR URT Notary Public
(p~~-~~ .
gy a~~~ D.C. My Commiuion sxpires
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(To b~ ~xaM~d 'u+ depiicat~,aad oripinai fil~d ~ Cira~it Cove~, and drplk~ wk~ Tax Aswara
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