HomeMy WebLinkAbout1236 Decl~ration ot Domiail• and Citi:enship
TO THE STATE AN~ GOUNTY TAX AS.SESSOR, ~ •
ST. lUC1E COUNTY, FLORIDA:
This is my deciaration of Domicile and Gitizenship in the Stete of Florida th~t 1 am fili~q this day in aco~rda~os and
in aonformity wiih Chapter 222, Sectio~ 22~.17, Florida StatuFai~~
NeN BurgL ~ ~I~x Yort
1 was formerly a legal ~esidenf of
(C1y) (Sta»)
and 1 msided at ~ 10 11l1tMi!! ~d . 1{owever 1 have char~yed my domidi~
• (Street and Number)
to and am and have been a bona fide resident of the State of Florida sinoe ~=Cb Z4 ~Y ~
,~q 69, and I reside at 1010 p~na. ~it.
(Street a~d Numbef)
I~ORT MERCE, SAINT LUCIE CQUNTY, RORiDA
and this statement is to be taken as my declaration of citizanship, actual legal ~esidence and domkile in the State of Horida.
qnsert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former tbmicile, removal of family to new domicile, purchase of home, etc.)
Placing childrta ia pablic school .
FILEO AND RECORDEO
S1F!l1B1~1~~COZIN~Y, F'i.A:
ST.filE~DR~ :V~~IFlED
~i~?'6111
' MAR 27. AMI 10:31
; ~
:~~u
I nOGER P TRAS
{ CLERi~• ~41RC~AT £OURT
~
i RJRTHER G'HtTIFY that I will comply with all other requirements of a leyal roaidsnt of this State. •
I FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I iMend to remain in FORT
PIERCE, SAINT lUC1E COUNTY, FIORIDA, pe~manently. _
~ (Name) P=sn~ AC r0 ~ ~it~
(/4ddress)
' Swom to and wbscribed before me this Z7 dsy af ~=ch , 19~_.
, .,,i . , , _ ~ .
,i. ,
-'t~, ~>Z '
~ ~-v :;~:~r s
_ : . ; ^ . . .
- ~
- • ~ : _ Notary Publk
- ' - ~ - .
gy ~ ~ ~ ~ ~ ~ D.C. My Gommiu'wn expires
~ - ~v'.-:,r: ~
- `~~J`I~~~~.~;,.•'~~J :'i"- •
'+.a~t~~• ` ' ~..5 . -
v~`~~"'. and ori~inal fiNd whb Ciwlc pra~ Couh, and duplieat+ whb Tax AsN~a
(Te b~
_ ~-=~-:s__~ . ~i76
- ,a
. _
~ _ . . z = , - - - - - . II _ _
z~3-~~ 3-~- Y.~-~~~-~~'.-; _ I ~V~ ,i~' ~ ~~"",~~y
I . i£ ~
~~}yi