HomeMy WebLinkAbout1121 ' /7~~ 34.
M ~ le ar~d Cltizenshi ~
} Declar~tion ot Do~nic1 p
~ TO THE STATE ANO COUNTY TAX ASSES~SOR,
,
ST. WCIE COUNTY, FLORIDA: ~ . ~
' This is ~my decia~ation of ~omicile and qtisenship in ths Stat~ of Horida that 1 am filin~ thit day in aooordana a~d
~ in conformiy with Chaptet 222. Settion 222.17, Fbrida Statutes.
I
j "heltar. ~ Gc~nilecticut
1 was formerly a le9al ~esident of
' ~C~ty~ (Sta»)
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and 1 ~esidad at 111 Pnnlar Drive - Huntin~?ton Howwer 1 h~w chanp~d my domldN
(Streat snd Number)
ro a~d am and have been a bons fide t~ident of tM Sist~ of Horida sinot ~Areh 24 ~y a;
, - _ _ ~q~~ ~ ~ ~ n 3045 Ccrte~ Btvd. ~
(5ft~t and NumbK)
FORT PIERCE, SAINT WCIE COUNTY; RORIDA '
and this :tatemsnt is to be taken a: my deds~ation of dtizsn~?ip, adual le~a) resid~na and domkil~ in fh~ Sta» of Horida.
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j pn~t here any pertinsnt fad:, wch u~le of property or busir~u, or rolinquishm~nt of ~nplaym~r~t -
~ at former domicile, romoval of family to ~ew domicile, purchas~ of fwn+s, ~ -
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;
Enterin~; children in Public school.
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David Rosa ~nd Heather =Zouise ~
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~ 1 FURTHER CERTIFY thst I will aomply witb all ott~ reqvi~~ts of a lepal ~ident of this Stats.
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~ I FURTHER CERTIFY that I have no inientio~ to rotum to my former domkile, and 1 Inter~d to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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is-~= .,5worr~•tQ~a~id wbsaibed before me this day of ~Q~#~ , 19_.b.~.
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~RQ;~,ER,POITRAS
CLERK~CIR R~`COURT - Notsry Publk
gy D.C. My C~mmissiom ~xpiros
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- (fo b~ ~x~wt~d ia dupite~t~ and oriyinal Ai~d wid~ CMrk Ci~wit Coue1, aud ~up~e~ w~ Tax Aa~ora
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