HomeMy WebLinkAbout1244 y~
acluatlo~ of Oon~icii• a~d CitiY~nship
TO THE STATE AND COUNTY TAX ASSES30R, r
2031~8
Sl. IUCIE COUNTY, FLORIDA:
This is my decla~atio~ of Oomicile a~d Citize~ihip in tFw Stete of Florida th~t 1~m filin~ this dey in sooord~~oe and
~n oonformity with ~hapter 22Z, Saction 242.17, Fbrida Statutes.
I was formeriy a leqal resident of
, ~
(City) (Sfah)
and 1 resided at _ • _ . Flowever I have than~etl my domic,~le
(Street and Numbe~)
ro aRd am and have been a bona fide resident of the StsM of Florida sinoe 3 ~ day of
e , 19~, and 1 reside at S v ~
(Street and Number)
FORT r1ERCE, SAiNT LUCIE COUNTY, IRORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residerxe and domiale in the Stste of Horida.
(Inse~t here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of Fw~r~e, etc.)
C
8~~UC
E CdUNTYRf~A.
ROCER POITRAS
CLERK CIRCY~ COtI~j ~
RECORO YERIFIEO
~M~1 ~L ~ 1 fl ~T'
` 2o31ss
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I RIRTHER ~HtTlFY that I will oom,Qly wlth all othsr requirerreenri of a lepal resident of this Stat~.
I FURTHER CERTIFY that I have no intention to retum to my former domiCile, snd 1 intend to remain in FORT
PIERGE, SAINT LUCtE COUNTY, FIORIDA, permanently.
. ~ / _
(Name)
~ 6 v~~~. ' L~~
F_
~ tAdd~~:~
~ ~
~ Sworn'x ibed before me this dsy of , 19~
~ `~~;z»ttt ti~~ii~ . -
~ ,~`R-~:r a`:~•p.~~~.;-. • ~
~ ~A~#~~R3itRlk~+' ~.-s
~ = _ Notsry Public
. - ~ - ~ t~="~;~-
By ~ _ D.C. My Gommission expires
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~ ~~~~89 P~E1241
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