HomeMy WebLinkAbout1171 ~
~ Decla~ation ot Domictlo a~d Citls~nship '
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TO THE STATE ANG COUNTY TAX ASSESSOR, i
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ST. IUCIE COUNTY, flORIOA: . ~ `
Thij is my decluation of DomicJl~ and qtis~nship in th~ St~t~ of Florida that 1 an filinp thi: day in aooordana and ~
in aonformlly wtth Ch~pter 2Z~. S~dion 22Z.17, Horid~ StatuMs. _ . ~
;t
! was torm~rly • Ipal nsid~nt of lbbile - Alibasa
(City) (5tata)
~ asoa ~v:~ Drive ` ~
and i rosided at Ho~vwK 1 haw tha~q~d my domirll~
(Str~et a~d Numbe~) • ,
ro and am and haw been a bona fide resident of t~t Stat~ af Florkla s~na Sth ~y ~
Ha~ r ~q 68~ 190a Ro~al PaL Dri~e
(StroK a~d Numb~r)
FOR? PIERCE, SAINT Lt1C1E ~OUNTY, I~LORIDA
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a~d this statemsnt is to bs take~ as my declsration af citi=en~ip, advsl lepal ~idenos and domioil~ in ths Statt of Horida.
pnsert hero any pertinent fads, such as sale of property or busin~u, or relinqui~t of «npiq?m~t
at former domiciis, romovai of family to eww domicil~, pvrchas~ of hpr~. Ne.~ .
8slabiisbing reaidence and sppl~i~ag for hoaestesd ~
i`7606$ ~
FIl.ED pND RECOR~~D • ~ _
. gT. IUC~E COUNTY. FL~• ~ .
?~.C~~tn YFR=~IrD
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~ '69 MAa 25 PM 3: 0~ .
=,e J_P ~•oi t Ras ~ -
CLERK C~RC~~T COURT , -
I FURTHER CHtTIFY that 1 will oompiy with all othet nquire~rwnts of a leyal raident of thit Stat~.
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1 RIRTHER CERTlFY that I havs no intention to retum to my former domic~le, and 1 inte~d to ~smain in fORT
PIERCE, SAINT~lI~CIE COUNTY, FIORIDA, psrmanentty.
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: _ Q~ Ukldress)
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` t:~ t!~~:rs,~:,:~~~~~ 2Sth I4ttCh~ • 196_q
• Sworn to and wbsaibsd befor~ rrw this day of -
' ROGER PORRAS
GRCUR COURT Notary Public ~
~y C~ c~e~Q~ D.C. My Commisiion ~cpi~
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(T. b..x~wt.a i~ d~pacat.,.~d «totnal fil.a wi1~ a.rk c~e+aat couey .aa dvpliea. whi~ T.x A«.wr,?
~ ~o K176 ~1170
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