HomeMy WebLinkAbout2653 O~cla~ation ot Domiail~ a~u! Citis~nship
TO TME STATE AND COUNTIf TAX ASSESSOR.
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Sl. ltlClE ~OtJNTY. FlORiOA:
This is my d~cl~ratio~ of Domicil~ u+ci C~tiz~nship i~ th~ St~t~ of Haid~ that 1~m filin~ thia day in aooordano~ ~~d
in oonformity with ChaptK 22Z. S~ction 22Z.17. Florida Statut~s.
Zisbon ~ Portugal
1 wa: fotmKly ~ Ipal taidant 9f
(ri~y1 (Sta»)
•nd I nstd.d ~t Filipe Folque ° 1 ~
(Stntt and Numb~r)
to and ~m •nd haw bsen a bons fids nsld~nt of /M Stat~ of Florid~ sino~ SepteIDber '
, i9 ?0, ~ , 9705 South Indian River Drive
(Stre~t a~d NumbK)
fORT ~~ERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is b be taken as my dedaration of citize~ship, actual 1e9a1 residenos and domicil~ in th~ Sta» of Horida.
(lasen hen a~y pertinent facn, wch as saie of property or business, or rolinquishm~nt of unplo~yma~t
~ ,~t formK domicil~, nmoval of family io Mw domicil~. P~+rchas~ of hon~, ~1c.) -
For homestead purpoees• :
~ LED AMU REC ' -
~ ~ IUCfE CflUNTY I.A. ~
• ~ ~ iIGCER POITR~S
~ 1tECORO VE~ FIEO c t
29 li 2~ I~'~ I .
~ 203982
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I FURTHER CERTIFY that 1 wlll oomply with ~11 ath+r nquinrr~nri ot a!pa! ~id~nt of this Stat~.
I FURTHER CERTIFY that I haw no int~ntion to ntum to my formK domiGls, and 1 i~trnc! to remain in fORT
PIERCE, SJ11NT U1CIE. GOUNTY, FLORIDA, pKmanMNy.
~ ( ms) 8oy 11. Pearce
:S:~~t~Nr;,
J' l.. (Adc~feis)
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' 29 January ?1
"'to ~-~t?b~uib~d b~for~ n'?~ thb day of 19
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• !G ~"4i~1'f. . Notary Publk
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B~? D.C. My Gommiuion ~xpins
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R~ b~ so~a~ M~plicaN a~ ~ri0isal ftl~d w~ G~4 CirwN Gwf, a~d drplicsN wi11~ T~x A~a .
e~i89 2645
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