HomeMy WebLinkAbout1731 2G3~~8~`
~ D~ala~atio~ ot Oomk~N~ and CitisMSi~ip
TO THE STATE AND COUNTY TAX ~?SSESSOR.
Sl. lUC1E COUNTY, FtORIOa:
This is my decla~ation of Oomitils and Citis~?ship in th~ State of Florida that I am filinp this d~y in aooo~d~no~ and
~n conformity with Chepter 22Z. S~ction 2Z2.17, Florids Statutts.
! was formerly a leyal resident of 1~~~ ~ f'1 lj ~ ' ~
Kiy) (State)
and 1 resided at _ `'u~Q ~ _ . However 1 have thanQsd my domkjle
(Sneet and Number) ~
ro and am and have been a bona fide ~esident of the State of florida sinoe day of
.w
_ ~ ~ , 19~, and I roside at ~ ~
and Numbe~)
FORT M~CE, SA{NT LUGIE COUNTY, lIORIDA
and this statement is to be taken as my dedaration of citizenship, actual Isyal residenoe and domicile in the Stete of Fiorids.
(Inse~t here any pertinent facts, such as sale of proper~y or bu~~ess, or mlinquishment of employment
at former domicils, removal of family to new domkik, purchase of home, etc.) .
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~ + ~T~`EUCIE CQUNty '
AOOEa PO1TItAf ~
CIERR CIRCWI
REC4R0 YE111i1E0
Ju~ 19 It oZ ~M'tl
2C348'7
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~ 1 RJRTHER CERTIFY that I will oomply with all othK requirsments of a lepal ~esident of thts State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
G-O O~.t-w_
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ti ' N'~' ~ 4~~. a a ; , - (/lddr¢lt)
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~ ~~~i'Yi~pd±~bscribsd before me this day of , 19~.
~ - .
~ . .,a~ir _
ROGER ~OiTRAS
~ RCUIT COURT Notary Public
~ ~
~ By D.C. My Commission expires
~
Qe b~ ~x~cvhd ie duplkal~ and ori~iwal fil~d wilb q~rk t~arff Ceu~1, and ~pllcah wilh Tax AM~o~.)
~ , ao~K ~8~ PA6E17~6 -
No. 13
,s~" s; ' ~i ; -
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