HomeMy WebLinkAbout0595 D~alaratio~ ot ~omiall~ and Citis~nshlp
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TO THE STAI'E AND GOUNTY TAX ASSESSOR, ~
51. LUCIE ~OUNTY, FIORIDA:
This is my deciaration of Oomicile and Citisenship in th~ Stat~ of Florid~ that 1 am filin~ thit day in aooordanoe and
in aonformlty with Chapter 222, Settio~ 222.17, Florida StatuMs.
I was formerly a leqal resident of Cincinati Ohio
(~ity) ~ (Stab)
and 1 ~asided at T8 JU11ef1@ld AVe• ~,~1Ve~~ 1 havecharped my domidle
(Street and Number) ~
to and am and have been a bona fide rosident of the State of florida sinoe l~t day of
January ,~9 68 , and I rostde at 513 S. 8th St.
~ (Street and Number)
FORT r1ERCE, SAlNT LUCIE COUNTY, RORIDA
and this statement is ro be taken as my detlaration of atize~ship, actual legai residenoe and domitile in tfie State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinqui~ment of employment
at former domicile, removsl of family to new domicile, purchase of home, etc.)
( School )
. ST~ L
CIE COUNTY. FLA.
RECORD VERIFIED .
' ' ` a"~
j ~0 At,~ 5 IW I i: 0~ -
! _ .
! ROG~R POITRAS
CLERK CIRCUtT COURT.'
1 FURTHER GERTIFY thst 1 wlil oomply with ail ott~ nquin~rwnts of a ipal rakl~nt of thls Stat~.
i FURTHER CERTIFY that I have no intention to retum to my former domicjle, and i inM~d to romain in FORT
PIERCE, SAINT LUCIE COUNTY, fIORIDA, permanently. $t@oe Tillett
.
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(Addr~ss)
Sworn to end svbxribed before m~ this 5 th ~y of AuBUS t , 19~.
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ROGER ~OITRAt ~ i) -
IRCIMT ~ ~11 a `J,~
= Notary Pubiic
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By O.t. My Commiuion expi~es
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~Te b~ ~oc~c~ iiu ' , f~d wNb Cl~k qraiM Gw~, and d~liaN witb Tax A~sia.1
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: . S~ i~ ~ 594
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