HomeMy WebLinkAbout0919 r
O~cluatio~ ot Oomlall~ a~d Citi=Mahip t
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FlOR10A~
This is my decler~tion of Domicite and Citinnship in th~ St~ti of Florida that 1 am filinQ this day in aooo~dana ~~d
~n co~formity with ChapM~ ~2Z. Settion 2~4.17, Florida Statut~s.
Chicago Ill.
1 wss formerly a teyal nsidMt of
(City) (St~ts)
end I residad at ._~549---~ast 91 8tI'e@t Howwar 1 haved~arped my domidk
(Stroet and Number)
to end am end have been a bona fide resident of the Stab of Florida sinoe 15 th day of -
_-~~camber , t9?.~, and i roside a~1.010 Bermunda Ave. ~
(5traet and Numbs~)
FORT NERCE. SAINT LtK~ COUNTY, RORIDA
and this staternent is to be take~ as my deda~ation of citizenship, actval leyal resider~ca and domiale in the Stats of Horida.
pnse~t here any pertinent facts, such as sale of property or business, or relinquishment of employment
at forn~ domicile, removal of family to new domiale, purchase of home. ~tc.)
Establishing residence and applying for~homestead
2~2939 ~
FILEO ~ND RECOft ~
iT. UIGIE COYMTY
ROCER POi -
CLf R!I C+RCd1T COUQT
RECORO YERIFlEO~.~.~. .
,~ll 5 2 50 P~1'1~
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1 RJRTHER CHtTIFY tfiat 1 will oomply with all other ~~quiremsnts of a(epal resident of thi: State.
~ I FURTHER CERT{FY that I have no intention to retum to my formar domicile, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. .
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' (Address)
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y Swe?1A ~o ~and subsuibed before me tfii: 5 th day of J~u~p , 19 ~
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ROQ~ER rO1TRAS •
CIRCtMT Notary Public
a~-~-.~L~i '
~ By O.C. My commissia? expi~.s
tT~ 4~ ac~cvN/ i~ d~iicat~ aed ~al ffi~l wllh Cl~rlc CkrwN Ce~N, and dvplkM~ wilb Tax At~~a
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