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Home My WebLink About2613 2~; 3~4:~ Y ? . O~cia~atio~ of Oaniail~ ~d Citis~nship ~ ~ TO TME STATE ANO GOUNTY TAX ASSESSOR, ' i s~. wc~E couNn, F~o~ia?: l This i• m~r dscler~tior~ of Oomicil~ ~~d Gitis~~hip tn th~ Stat~ of Norid~ that 1 an+ fili~+q thit da~l fn aooord~na a~d i~ oonformiiy with ChaptK 22~. S~ctbn ~~Z.17, Florida &atuta. I w~s formuly • Irpai ~id~t of C~'L 2f1'P~ ` • . (rtty) ~ (St•t~) . , and 1 nsidtd ~t ~ fC~Gt~ " . NowwK i tNw tha~p~d domiCili . (Str~et ~nd NumbK) ro~nd am and haw bMn ~ bona fid~ ~id~nt of t~ Stat~ of florida dna J~ld~~ /U - -~y ~ , 19 70 , and I hsid~ a ~ ~1 ~ ~ ,~in~~ (StrNt and Numb~r) FOR? t1ERCE, SAINT IUGi COUNTY, RORIDA and this statement is b be tak~n as my declaratia+ of atiz~hip, actusl ipal ~~sid~no~ a~d donnidl~ in th~ Sta» vf Fiorida. ~ • € (In~t h~re any pKtins~t facts. wch as sal~ of propsrty cr busin~u, or nlinquishment of smploym~nt ~ ` . ~ at farmK cbinicii~, rmwval of family to nrw domkil~, purcha~ of ~wn'k, Nc.) ~ Homestead ~ 2Q3949 ~{lED ~lID RECOft~E'0 tT. LiiC1E C~tIMjY FtA. Aoa~a ~o~ttu? C~E1tX ~iRCWT RECOItD YERIf1E0 . J~ 18 3 ~2 PH'11 _ ~ ~ . - ~ ~ f ~ E . ~ 1 FURTHER ~HtTiFY that I will oomply with all athK nquir~~ri of • Ipa! rpid~M af this St~ta 1 FURTHER CER7IFY that I have no intention to ntum ~o m form~r domical~, and 1 i~tend to nmain in FORT RIERCE, SAIN7 IUCtE COUNTY, FLORIDA, permanently. ~~S S~~~a~ ~ ' . ' e rsa ~ ~ ~ .~~''`~1tt~~r~Itklt~~~~~ ~ ( ~~..~`L6fi.11 l~l ~!/'PJ • . ~ . ~ C ~i~~ (~1ddr~ss) ~ ~ ~ . : ~ J•~• . SW;,OfA ~O.~i~ ~1/~~ ~fOff R1A ~115 ~ ~T~ ~y Of 19~ w • t:7. " ' • . - t~:- . . • ~ ; ~ i~~:t+., _ . ~ : ~ . ; ~f ,~tAriiA~'•- . ' ~~p~ ~ Not~ry PuWk t ~»>i~,~ gy ~ G.C. My Can~s?is~io~+ eupins . Q~ Ir~ ~x~cw~d i~ deplical~ a~ ~i~al fil~i wi~ C{wlc CirsrM Gw~, a~i ~isat~ wilb Tax A~~a ~ 640K ~ h;`*a. i ; _ ~ . -,.n ' - - ......r. s.;'~.r ~.,~?'.sc'~v~- r~-~ y ~`x - ~~x'I~,k* - , _ -'8'~,s~~~'~"#~=~'~~~~k`~`~~ _ ' . "