HomeMy WebLinkAbout2654 ~claratio~ ot Domiall• a~d Citl:~nship 2~}~~3
Tt~ THE STATE ANO COUNTY TAX ~?SSESSOR~
Sl. IUCIE COUNTY, FLORIOA:
Thii ii my d~cl~r~tbn of Oomxil~ and Citis~nship in tM St~t~ of Haid~ that 1~n+ filinp thi~ dar i~ ~ooorda~?o~ a~d
in conformity with Chapter 2Z2, S~ttion 2~Z.17, Florida Stetut~.
1 was formKly • Ipal hsident of ~
CCity) tah)
and 1 rosid~d ~t ~ ~ How~vK i haw chanqsc! my domWl!
(St»st and Numb~~) ~
to ar?d ~m a~d haw besn a bona fide rosident of t~ Sta» o# Florida ~inos ~ O < • ~Y
, 19~, and I ~id~ at ~J "
~ . ~.e . (Stre~t and Numbe~)
l~ORT ~IERCE. SAINT LNtiE COUNTY, RORIDA •
a~d thii :taterr~snt is to be tsken as my declaration of citizenthip, actual legd rosidencs and domicile in ths State of Horida.
. . pnsert here any pertinent facts, such ss sale of property or bu:in~u, or mlinqui~ment of employm~nt
at former domicii~. ~r~ov~i of family fo n~w domicile, purchas~ of hornt. ~tc.)
~ ,
Homestead 2~~98~
F ~p ANO RECOIi~~ '
. ~~.~t1C~E ~pp~T~RAS
ROC CiAG111S ~0
RE~~O ~~~lf fE0
- 2' -112s AM'1 t ~
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1 RJRTHER CHtTlFY that 1 wili oomply with atl otfwr nquintrwnis of • te~al rasidsnt of this Stab: ~
1 FURTHER CERTIFY that 1 have no tntention to rNum b my domivie, and 1 intend b r~msin in FORT
PIERCE, SAINT ItJCIE COUNTY, fLORIDA, p~rmansr?tty.
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° ''•'~y~ ~i~'~`'~' ' ROIdEY B. SCRIBBER
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Swrer,q j~.ii~d.:ubstrib~d befor• m~ this day of 19~.
ROGER ~ORRAS _ .
CL~RIC CONRT . Notary Pub{k
c
sy o.c. ~ MY c«~„~u~+ .xa~
(T. r..~c.aM~ iw drplic.~. .w~ ..i~i~al Kl.a wili~ a..k ciewrit c.wt, .ea dupikat. wi1~ T.x A~....0..1
aoa 189 2645 .
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