HomeMy WebLinkAbout2648 . •
D~cla~atio~ ot Dom1~11~ a~d CItlsMahip
' TO THE STATE AN~ COUNTY TAX ASSESSOR. ' !2U~,~ j
Sl. IUCIE COUNTY. KORIDA:
This is my decl~~atiwl of Oo~++icil~ and Citis~nship i~ th~ Sat~ of Florid~ that 1~+ fili~p thi~ day in aaoordana a~+d
i~ oonfotmity with Ch~ptK 222. S~ttion 2Z~.17. florida Statut~.
1 was forrtwrlr ~ Ipal nsid~?t of fP/Q~il~ 6- ,~C~'/~~J'L~'~~
' Kih?) tSta»)
and 1 residad at O~0 G/~AG~L~_~~~ . H~vvtvK i haw charp~d rny domie~l~~
' . (Str~et and Numb~r) -
ro and am and have baen • bona fide raid~nt of th~ Stat~ of florida sina day of
.~9.,2L, ~~w. n~~D~ ~3 ~l9~rf~ ow~~e ~~.v~
(StreN and Numb~r)
FORT PIERCE, SAINT LUClE COUNTY, RORIDA
and this statement is b be taken as my declaration of citi~sr?ship, adual Ipal residenos and domicil~ in ths Sta» af Florida.
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p~sen here any pertinent facts, wch ss sale of propert~? or busintss, or rolinquisitim~nt of ~mplo~ym~nt 4
at former daniciiw, romovsl of family to ~n~w domicil~, purchas~ of horrw, a~cJ '
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1 FURTHER CERTIFY that i wiil oomply with ali oth~r ~puit~nenn of • Ipal ~uidMt of this St•t~. -
1 FURTHFR CERTIFY that I have no intention b r~tum te my form~r domidl~, ~nd 1 intMd to r~main in fORT
PIERCE, SAINT WCIE COUNTY, FLORIDA, pKman~ntly.
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~i .,SwsAp~;d'a~i :ubscribsd b~for~ m~ this day of 19_L./
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~ -;Cl~k~. COIIRT Notary Publk
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6y O.C. My commissio~+ .xpsn.
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aoo« 1~9 2640 '
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