HomeMy WebLinkAbout1074 1~`7129 D~aluatla~ M oomial~~ a~ CltisMShip
Tp THE STATE AN~ ~O~JNTY TI1X ASSESSOR,
s~. wciE counmr. aoRia?: .
Thls is my d~cl~r~tion of Domicil• ~nd Citi~nship in th~ Stat~ of Horida that 1 am filinq fhis day in ~ooordana a~d
in aonformity with Chapt~? 422. S~tlion ~Z2.17, Florida St~tuNt.
1 was forme~ly a Ipsl rosid~nt of HBrteO111• 8011~h Car011IIa
~ctN) lS~.a)
end 1 ~esided at _ Rt 2~ YoBes FbvwvK 1 haw thaiq~d my domidl~
(StrNt and Numb~r) . ~
ro and am and hays been a bona fid~ rosW~nt of tM Stah of Fiorida dno~ 5'~ day of
d~8t - .~9?~ ,,~d ~ n,~d. n 471 Solss ire. ~ -
(StnN a~d Numb~r)
I~ORT M~CE, S~AINT WCIE COUNTY, RORpA -
and this statement is b be taken as my dedaration of ati~enahip, actual Ipal residsno~ a~d-domkil~ in th~ State of Hocida.
(Insert here any peninent fads, such a: sale of pr~operty or businsss, or rolinguishm~nt of ~mplayn+~~t ~ -
at former domicile, removsi of family ro new domicile, purchast of homs, ~tc.)
Zrying~8ay - 8th Grads ~
8o,ndy I,ynn - 6th arada
goll~ I~eigh - 3rd Grads -
~ FICEO ANO RECORDEII~
- S?.RECOR~ VE~YED~
- ~ 19`7~.29
~~zo auc i 3 a~ io :~as
~ p~ie -
~ .
E ROGER POITRAS ~
~ - . CLERK CIRCUIT COURT' ~
1 FURTHER CHtTIfY that 1 wiil compiy with ail atF~ nquirwrMnb af a le~al r~kl~nt of this Stat~.
- 1 FURTHEQ CERTIFY that I have no -intention to rMurn Io my former domicjl~, and i int~nd to ssmain in FQRT
PIER~E. SAINT LUCIE COUNTY, fLOR1~A, perme~enNy. ~~uiim $8T1 ThOaBO ~ Jr.
~~~1~ ~
- cr~.m.~
~
(Add~s)
s~orn b..nd ~,lu«~b.d bsfor. n,. this 13th d,y ~ ~U,g1iSt 19 ~0,
.
.,~r
j~
ti~ . t,
rf``~
r~~ 0 . Notary P~tk .
. ~
~
- - . • .
~ ~ ~.C. My Comn~is~ion ~xpins
.
- ' =
? ~~r {C~b,;;• .
- ~ ,'~~,e~ ~
v.Y.'~,. - ~ .
~ i~MtaM a~i ~ei~i~a! fii~ wi1M CM~It CiraM Gw~ a~ i~MNM wM6 Trt ~NN.1
~ ii~; ~ . ' ~
~ ~.rt,~,~=s,~~~,:~~ . a~~186 ~1073 _
M.. u ~ .