HomeMy WebLinkAbout1644 D~claration of Domiait~ ~nd Citis~nship 1'76415
TO THE STATE AN~ COUNTY TAX ASSESSOR,
ST. UJCIE COUNTY, FLORIDA: .
This is my declaration of Domicile a~d Citizenship in ths State of Florida that 1 am filinq this day in aooor~dano~ and
in aonformity with Chapter Z22, Settion 222.17, Florjda Statutts.
I was formerly a legal resident of ~~et~ Ne~r HaaDshirt
(Clty) (Stat~
Rt 4 Bpx Z14
and I roslded af . Nowever 1 hav~ thsrp~d my domkll~
(Street and Number)
to and am and havs been a bona fide rosident of the State of Florida sinoe li! ~y ~
Octobe= 68
, 19 , and 1 fAS~ at'~11A A7~~wd~r ~r~
~ (Stroet and Number) .
fORT M~CE, SAINT Ll1CIE COUNTY, RORIDA ~
and this statement is b be taken as my decla~ation of citi~enship, actual legal residenoe and domiale in the State of F{orid~.
pnse~t he~e any pertinent facts, such as sale of property or busineas, or ~elinqui~ment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) -
Bstablishing residence and appl~io~ fos h}~~~ R~CORpEp:
ST, LUCiE COUNTY FLa:
RECORO VE~~g~ED
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~
ROGER ITRAS
~.ERK CIRCUlT COURT;
~ ~
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~
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` I FURTHER GERTIFY that 1 will oomply with all other requireme~fs of s lepal ~ident of this State.
I FURTHER CER~'ifY that I have no intenfion to retum to my former domiCjle, and I intend to remain in fORT
PIERC;E, SAINT UJLI~~E4UI~SFLORIDA, pe~manently.
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- - , . . Y~onne Zieleaslci ( Mrs Pranl~ )
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~~~~vG~x~`itti~ ~j~iid:;subscribed before me this lst ~y Lerii , 19~4.
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CIRCUR COURT Notary Public
gy D.C. My Commiuion expiros _
(Te b~ pc~cuNd in duplicat~ snd oei~inal fil~d wilb Cl~k CirwN Couet, and duplicsh whb Tax A~Maa
~ ,a 800K~~6 PAGE~V~~
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