HomeMy WebLinkAbout0777 O~aluatlo~ of oo~r~i~i~ ~1 C~lls~ship .
r0 TNE STATE APq QO~NdTtt TAX ASS~SOR. ~
s~. ~uc~ couNnr, aoR~a~?:
Thls is ~r d~dK~tion of Oomicil~ ud Citi~nship in th~ StaN ~ Florid~ that 1 ann fili~p thu day in ~aoord~~ a~d
in conformily wifh Ch~pNr Z22, S~ttion Z~Z.17, Norlda Sfatul~s. ~
~ w,~ ~~~y , i~~ m~,t ~ ~winahe~t~r Virginia
KrN) (Sta++)
.nd 1 nsid.d at 3C1 Foz Dr. - ~ . Ha~v.r i h.w chan~.e! m~? domki~
(StrNt a~d NumbK) .
to and am ~r+d Mw b~+r+ ~ bona fid~ nsid~t of tlk Stat~ of Florida slno~ 'S18 t~ ~y
July ~q ?o , ~ ~«w. ~ 5oL? Pavn ave.
(Stnet and Number)
lORT SAMlT LUCIE COIMITY, ltORIDA -
a~d this shterr~snt is ro b~ tak~n as my dsdaration of cit~uhip, actual Ipal resid~~a and domk+l~ in tM Sta1~ of Horida.
pnsKt Mm any pertinsnt facts, wch as ssl~ of proputy or businsss, or nlinqui~m~nt of employm~m
~t to~mK domicile, renwval of hmily to n~w domkik, purchas~ of har~. Nc.)
( Hoieatead S~cesption }
. . ~ FIt~D AMD R~;p~p Q~,- .
~ ST. LUGIE COUN'TY, ~ -
~ - RECQRO VERlFIEb
. . Z96936
~ 'TO AU6 t 1~M 10 : 89
~ _ ~o~~
: _ ROGER POiTRAS
~ CLERK CIRCUIT COURT~
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~ i FURTHER C~tTfFY that 1 wiil oompiy with all othK ~nquinrr~tb af a Ipal nsid~nt of this Stata
1 FURTHER CERTIFY that 1 have no intention to rotum to my former domic3le, sr~d I intend ta remain in FORT
w~tcE. Sn~M u~c~E Couwnr, RoRiDa, permanenrly 11111iam Ware (Yrs. Lorralne }
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(Nam~)
~ . (Addross) .
Sworn to an~ wbscrib~d before ms this lOth ~y ~ AuguBt , 19 70
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' •,y;.xltNr~ ~ _ . .
Notary Publk
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9~? ' ~ - ' ' . ~ C. My Gomrnission ~xpiru
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