HomeMy WebLinkAbout0745 D~cla~atlon ot Oomlcll~ and Citis~~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FLORIDA: 2«282i
This is my declaration of Domic+le end Citi=e~ship in the Stste of Florida that I am filin9 this day in scoo~d~nce snd
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~n confo~mity with Chapter 224, Section 242.17, Florida Statutes.
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I was forme~ly a legel ~esident of _N.~ 1~~~~~-~_.____
(City) (Stete)
and 1 ~esided at J_a N t_~Y~~ L E _ l. ~N b?OOCf AIrF _~!Z_~I Howevet I have chanqed my domidle
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since day of
- - - 19~~ and I reside a~ : 1fh .1~ - T -
(Street and Number)
~ d . S_ t=~ 1 - ~f. ~,.u~ ~ 1 A „
fORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declarotion of citizenship, actual le~al rasidence and domitile in the State of Horida.
(Insert here any pertinent fads, such as sale df property o~ business, or relinquishment of employment
at fo~mer domicile, removal of family to new danicile, purchase of home, etc.)
Sh~}r y ~E/VAE ~J~~brd~/{
f LEO ARO NECOR~E~ l
s~.lUC1E COUMTY ~ 1
ROCER POIMAS ~J
- RECORD YEaRF1E0~ -
~I 9 0~ AM'1!
~ 2G2821
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~ I FURTHER CERTIFY that 1 will oomply with all other requirements of a leflal resident of thi: State.
I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
C~o'
Name) G ~ r o c.1
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~ i . ' . C'~'"f~ : (Address)
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~ • Swqrn to'atx~ subxribed before me this day of , 19~
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~ ' '~AK^CIRCUIT COURT Natary Public z
~ By O.C. My Commission expires
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(To b~ ~x~cvl~d in duplicat~ and wi~inal fil~d whl~ C1KIc Grarit Court, •nd duplicat~ with Tax At~or.I ,
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