HomeMy WebLinkAbout1637 O~Ct~~ation ot Domiall• a~d Cltis~nship
TO THE STATE MI~ COUNTY TAX ASSESSOR, O A_~~
a3~
Sl. lUC1E ~OUNTY. FtORIDA:
This is my decl~r~tio~ of Oomicils •nd ~itisenship in th~ St~M of Florid~ that I sm fllin~ fhit dsy in aooord~~w and
in oo~formity with Chapter 222. Settion 22~.17, Florida Statuhs.
1 was forme~l a 1 al ~esident of l11Q-~~~[dd,~_ ~ ' _
Y ~9
(City) (Stah)
and 1 rosided at • _ . However 1 have chsnq~d my domidle
(Street snd Numbar)
to a~d sm and have been a bona fide rosident of the Stab of Ftorida sinos a'~ ~ de of
Y
, 19 , a~d 1 roside ~t
(Stroet snd Number)
I~ORT'I~CE, SAINT LUClE COUNTY, ROR~A
and this statement is to be taken as my declaratio~ of citizenship, attual legal residenee and domicile in the Staro of Horida.
(Insert he~e a~y pertine~t facts, such as ssle ~of property or business, or relinquishment of employmsnt
st former domicile, ~emoval of family ro ~ew domicile, purchsse of horr~e, etc.)
Ho~estead ~ LEO 4MD ~ R "
WCJE C~Up~
CIERK
C
RCUIt
QpyAT
~1ECOR0 VfR~p~EO
~ 18 10s~ AN'~f
2G3448
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€
S
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~ I FURTHER CHtTIFY tfiat 1 will oomply with al) atl~ nquirenner~b of a Ispal msidsnt of this State.
1 FURTHER CERTIFY that 1 have no intention to return to my form~ domiCi~e, and I intend to remain in FORT
PIHtCE, SAINT LUCIE COUNTIf, FLORIDA, permanently. -
( ame) .
Charl~s 3t~prf r
Q
~
~ (/01~feti)
::f:i~~~
~ - ~~,,fJ~`~ 1e J Tl
~ `~;~`,~ywdt~ subscribed before me thi: day of , 19 .
~ _ 'r~- ' ~1 .
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, M ' M •~~~~~~~ir~
• ' ' ; ~ ~O~'~ Notary Public
~ . ' ' ' . - .
~ gY • , ` D.C. My Commission ~xpir~t
-
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~ Re b~ ~x«ar1~d M dvplieaN ~nd oei~inal fN~d whl~ q~ C,MarM Caret, and deplkM~ whb Tax AM~aa
~a~ 189 ~,~1?~r~
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