HomeMy WebLinkAbout1365 ~cla~atio~ ot Domicfl• a~d Citis~nshlp
TO THE STATE ANO COUNTY tAX ASSESSOR,
Sl. lUC1E COUNTY. FIORIDA: -
This is my declaration of Domicile and ~itizenship i~ the State of Florids that 1 am filin~ thi: day in atoord~nos and
~m m~fo~mity with Chapter ?22, Section 222.17, Florids Statutes. ~
I was fo~merly a legal resident of F'~~DO~"t I+. I. ~1e~? Ynrk _
~ (City) (State)
and I resided at _ 44 HaseBU ~wever I have changad my domi4le
, (St~set and Number)
to and am and have been a bona fide ~esident of the Stste of Florida since ~uHuet 2 day of
- , 19~Q, and I reside at 126 I.akehuret Drive Port St I,ucie
Fort Pierce, Florida (sheer a~d Number)
fORT PIERCE, SAINT LUCIE COUNTY, F10RIDA ~ •
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(I~sert here any pertine~t fads, such as sale of propery or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of~fiomg, ett.) '
Placing children in school
FIL~D AND RECOR~ED~
$ric aad Yarc 8okaw ST, [,UCIE COUNTY. FLA, ~
R~CORD VERIFIED
~ ~ 19`7344
'TO AUG 18 pN 2: S 1
ROGER ROtTRAS~~ ~
CLERK CIRCUIT COUR~
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I FURTHER GERTIFY that I will aomply wltfi all other requirements of a le~al resident of this Stste.
€ I fURTHER CERTIFY that I have no intention to retum to my former domi~ile, and I intend to remain in FORT'
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) A11an$8okaw
y . -
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~ . : ~af - (Address) .
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~'~~~~~±~`ji ~ ~
~ ~ •`~`•=.,r'. `:3~L:~i~~'~ . . ~8 J~u uBY 10
~ ' Sw~orn ~o-a~ wbstribed before me this day of - g 19 .
~ .4 ^ I
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~ ~ '~IpT C RT Notary Public ~
BY O.C. My Commission expirss
(To ii~ ~x~eubd in dupfieat~ and oriqlnal Al~d wilb Cl~eic Gn~M Cewt, and dupNeaN whb Tax As»~.I
» a~i~ ~i~ .