HomeMy WebLinkAbout1726 D~alaration ot Domlall~ an~ Citis~nshlp
TO THE STATE AND COUNTY TAX ASSESSOR, ~ . ;
S1. LtJC1E COUPiTY, ~LORI~A:
This is my decl~ration of Domicils sn~i Citiunship in th~ StaN of Horida that 1~m filinq thit day in aaoord~no~ and
in oonformfty with Chapter 222. Ssttion 222.17, Florida Statuht.
. I was formerly a leyel residerst of ~ina~burg, Ohio
~ _ . - Kiy) ~ (Sta»)
~ 2656 Aurora 8oad ~ ~
and 1 retided at . Howwer I have chsn~d my darWk
~ - (Stn~f and Number) ~ ~
ta ancl am and have been a bona fide residant of ths Stat~ of Florida sinoe a~~ 7 day of
,~9 a~d i rostde at 1T53 8eaway Dr1vs
. (Stroet snd Number)
~ n~c~, sn~ tuc~ couNrY, ao~w
and this statement is to be taken as my declaration of uti~enshi~, actual le~al residence and domidle in ths State of Horida.
pnsert here any pertinent facts, s~d~ as sele of propsrty or buainess, or mlinquishment of employn~nt ~
at fonner domicile, mrrwval of family to new domiale, purd~ase of home, ~tc.) _
$etablishing residenay and clai.aing ho~eetead.o=snption~
FlLEO ~ANO RECORDE~`
3T. LUCIE -COUNTY. FLA.
~ RECORD VERIFtEO
19549 ~
- '10 JUt ~ AM 9 ;~g
; ~ -
- kC~vER t~01T
~ ~ ~ CI.ERK CIRCUIT COURT;
. ~
~ 1 RJRTHER CER'TIFY thst I will oomply with all ott~ nc~uirurwnts of a Ipal r~ident of fhis 3tah.
~
,
~
~ I FURTHER CERTIFY that~ I have no intemion to retum to my former don~iale, and I intend to remain in FORT
~ PIEltCE. SAINT UJCiE GOUNTY, fIORIDA, parmanenHy. ,
~ f ~
~ L~
~ : pVam.) °
~ -
-
~ (Addr~ss)
~ - ~
~,tt:'t.tr.r•,~ ° - -
btfor• m. thi: l~t d.y ~ Jul~ t9~4 -
;~M~otn ~D ~ subit~ib~d .
. f r,
• ~ ~ cti - ~'4.
~ ~~•y / . ~ . .
4 ~ -
~l;.j~- ~
• . • ~ ~
~ • =~w~c ~ ~fw'y PI,~IiC
-
a-~.;:
~i'~ O:C. AAy Cor+wni~ion ~xpin~
. .
L~.:.
_
•
R~ M~MaM~ M~/11 M+ M~Ar ~i~ ~~f/~ M+ ~MI~ MI~ T~
~ „ ~185 ~i~~T .
. _ : _ .
-