HomeMy WebLinkAbout2376 O~ai~ratlo~ oR pon~iall~ a~d CiNsMSINp
TO THE STATE M1D COIJNTY TAX A53ESSOR,
Si. ItKIE COUNTY. FLORIOA: ~ ~ ~
This is my daciu~tlon of Oomicil~ and CitizMShip in th~ Stah of Florida thaf 1 am fili~p thit day in aooo?dinw ~~d
in conformlfy with Chapta Z2~, 5~ttion ~42.17, Florida St~tut~s.
I was for~ly a Ipal msid~nt ot _+~~ii~ ~sntb a.roli~a
tCiy) • (Sts») ~
and 1 resided at S D~Z ~ . HowevK 1 have chanqsd my domiCik
(Str~et and Number) :
to and am snd hsve besn a bona fide rosident of the Stsro of florida sinoe day ~
193Q_, and I rosids at ~Tl ~las LihAM ,
(Street snd Numbsr)
I~ORT MERCE, SAINT IUCiE ~OtiNTY, R~t~A
and this statement is ro be taken as my declaration of citizenship, actual legsl residenos and dornicile in the State of Horida.
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pnsert here any pertine~t facts, such as sale of property or buainess, or ~elinquishment of employmant
at fomnef domiale, removal of family to new domicile, purchase of home, etc.) '
?a~q S~. ?~wu ~sd Ji~ ~ll~n ~ra ~t~rfai_eYildtrs i~ seti~el)
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- FI1~D ANp RE .OR p_ ~0~
- : . ST. ~UCIE COU~;~~~.A;~
RE C 0~~1~,~~~,p
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. - '10 dUl 14 AM 10:08
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i~o~~a ~o~rRas
CLERK CIRCUiT COURT!
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1 FURTHER CERTIfY that 1 will comply with all ofher roquiremsnn of a lepai resident o~ this Stste.
1 FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCI~ COUNTY, FLORIDA, permanently. ~
- l C~ ~~1~7r~.~~.
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_ . (Name) L~mi• E 'l~asr
' :y~.:=.--. - ~ (~1cWress) .
:..::5;(:l~jj
.%~[l . -~~rli.Y~:
~ `.rs ;~;~1
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~.~~~~ls+~#Cribe~J before me this 14~ day of , 19 ~
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~~~E~tIRT tVotsry PuWk ~
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By ~ ~.C. My Commission expire:
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(Te b~ ~xsaN~d ~ d~pNea1~ and e~l Al~d wMl~ Cl~ek CMa~N Cow1, and d~IkaN w~ Taac A~o~a
eooK1~5 ~ -
lio. 13 . ~
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