HomeMy WebLinkAbout1590 aciaration of Domlalia and Citis~nship .
TO THE STATE AND GOUNTY TAX ASSESSOR,
ST. lUC1E LuJNTY. FLORIDA: '
This is my declaration of Domicile and C~ti~enship in ihe State of Florida thst i am Nlirp fhis day in aaoordano~ a~d
in aonformity with Chapter 2Z2. Settion 22~.17, Florida Statutes.
I was formerly a legal resident of ~*COL ~i•
tC~hl _ tStatr)
and 1~ided at RPD ~ . Hovwver 1 havs d~r~d my domidl~
_ (Stroet snd Number)
to and am anci heve bean a bona fids rssident of the SteM of Floride sinos ~C • ls daY ~
, 19b~ , and i rostde ~ 341 araaada $1'rc~t'
(Stroet and Number~
PORT N~, SAiNT LUCIE COUNTY, RORIDA . ~ ~
a~d this atatement is to be taken as my declaration of ati~enship, actual lega) residenoe and domidle in the State of Horida.
pnsert hero any pertinent facts, such as sale of property or business, or rciinquishm~r?t ot employmant
at former domicils, removal of family to new domiale, purchsse of home, etc.)
ho~eatesQ pnrpsses
RILEO ANO RECORDEO
ST. LUCIE COUNTY. FLA.
_ ~ R~C4RD VERIfI~D .
1`76384
~ '69 APR I AM I I: 39
NOGER f'OlTRA~
CLERK CIRCUIT COURT~
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; 1 FURTHER CfRTIFY that 1 will oomply with all other requiremenb of a le~sal resideM of thi~ State.
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~ - I FURTHER CERTIFY that I have no i~tention ro return to my former domicjle, and I inte~d to rert~ain in FORT '
PIERCE, SAINT LUCIE COUNTY, FLORIDA, pernnanently. .
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~ _ (Name) Blsi Nl~11~sa~
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~ (Addross)
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Srworn to and ~bsuibed before me this lat day of wnr3t ,~q~q
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; - ~ItT~ Notary Public -
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By ~ • ~.C. My Commission expiros
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Sf~~ s~~-~ac A'
(Tii#~, r.'11~'~drpiitaN sed arioin~l Rl~d wieb Cl~elc Ckwif Ceur~, and ddpi~N wiN~ Tax A~ora
: ~ ~o~ 176 ~ ~588
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