HomeMy WebLinkAbout0353 Declaration of Oorr~i~ile and Citisenship
~O THE STATE AND COUNTY TAX ASSESSOR, ~
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Sl. IUCIE COUNTY, FLORIOA:
Th~s is my declarat~on of Domiule and Citizensh~p in the Slate of Florida that I am fil~ng this day in accordance and
~n conforrnity with Chapter ?22. Section 22?.17, Florida Statutes.
I was formerly a legal residenf of ~n COntl~Ilg 1~Ch~qAII #
(Ciry) (State)
b622 R:Ichardeon Road
and I resided at _ _ However I have changed my domiCile ~
(Street and Number)
+o and am and have been a bona fide resident of the State of Florida since ~Ptember Ib day of
, 19~~ , and I ~eside at 58I10 SOUth Fsdlril_
~~i~eei and t~tumoerj
FORT PIERCE, SAINT tUC1E COUNTY, FLORIDA
and this statement ~s to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(I~sert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal af family to new domicite, purchase of home, etc.)
Establisbin{t teaidency - placin~ children in pnblic sohool
(Rand Aobinson) /
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FILEO AND RECORDEO~ ,
ST.~FC~RC ~uR?FiEOLA~ _
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'10 SEP 18 PM I: 0 ~
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ROGER POITRAS '
CLERK CIRCUIT COURT~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~
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1 FURTHER CERTIFY that I have no intention to return to my fc+rmer domi~ile, and I intend to remain in FORT ~
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~ F!ERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) ~Ilias Ili~oan
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~ ' ~aAd subscri6ed before me this _ 1$___ _ day of ~~i~~ll _ . _ 19___ .
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~ ROGER POITRAS - - - - - - - `
CLERK CIRCUIT COURT Notary Public ;
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gY - Q.C. My Commission expires
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(To b~ ~x~cut~d in duplicat~ and ori~inal ~il~d with Cl~rlc Circuit Court, and dupliuh with Tax Ass~aw?.)
~ 187 353
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