HomeMy WebLinkAbout2659 . ad 2U~t3~' Y.~
Watu on of Oomlati~ a~d Citis~nship
TO TNE STATE ANO COtJNTY TAX A,SStSSOR.
Sl. 11JC1E GOUNTY. KORIOA: ~ .
This ii m~r d~clu~tion of Domicil~ ~nd Citi~nihip in th~ Sta» of Florida th~t 1 M+n filinp this day in ~aoor~dana Md
i~ co~forrMty with ChaptK 4Z~. S~ttion ~44.17. Horida &~tut~.
~ YINi fOffllYf~r • ~p~~ ~liK~ftt O~ ~(~~f"j~'q:• n n n w.( ~~13
C, i
~nd 1 hsided ~t g
6~ ~i~,~Q"'" How~vK 1 hav~ danped my cbmWle
(Sthet a~d NumbK) -
to and ~m ~nd haw baen a bo~a fide ?~sid~nt of th~ Stab of Florida sino~ •~d~ Jr~ ~°l d day of
, 19 , ~nd 1 ~iti~ d ~~3~1 ,~I~, . ~ GL,.d.,,..~,~i ~vt~
(Sin~t and N mbe~)
!'ORT NERCE. SAINT Ltl~lE COUNTY, RrORIDA
~~d thit statemsnt is to be taken as my decla~~tion of atize~ship, actual l~yal res'~dence and domicil~ in ths State of Florids.
(insert hsre any pe~tinent fads, wd~ as sale of property or butiness, or ~elinqui~m~nt of ~np{oynwnt -
d formK domicile, rorrwval of family to n~w domicile, purcha~ of hon~. ~tc.) .
,
HO1dES T£kD
. ~ 203987'
• fllE~ ~tNG RFCORp~E ,
. t~lE COUNTI~ Fl ~
ROCER POItRAS ~ t
'A6CORp y ~«~Ult COb
fRIF?ED - .
. . ,1'~" 29 ~ ly ~T~ ~
. •
.
~
~
~
~
;
t
. ~
f FURTHER CHtTIFY th~t 1 will comply with atl ofFwt nquit~rrwnb of a Ipal ~id~nt of thi~ Stat~. `
,
I fURTHER CERTIFY that 1 haw no ints~tior~ to nfum to my formK domic~le, and I intend to rsmain in fORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, p~rmansnNy. jNN IE B(1U SE
- .s:itrl~ .
. ~
~~~tN)ttt ft~iy~~ '
: ~ C a ~ ~i.~ " : . / i/ l~~t. ~ OZ~/~~ .
~-y
~
~~~lY}1~,l ~ 4 ~ . ~ ~ ~~N~ .
. ~ : • v ~ ti ;v _ .
_ ; ~ ~ K G.
~ ~ ~ • ' • ~ ~ 1~
! ~ ~i • -a~ G: i r:r ' L I ? C~/~/'
~ ~ j
~ t" r , _ (~t~d~KS~
t ~ ti. . ;:~~;fi -
~
.,,,.C~ _ • , T
f 'r`
~~i~~id~~ptt~wbsuibsd befor~ tnt thit r~=- day of 19
ROGER ?OI?RAS •
1T COIMT , Notary Pubfk
?
By h'`r O.C. ~ My Commiuion ~xpi~
~ ~
R~ b~ ~x~arhd iN dvp{ica1~ a+d ~i~iwal fil~d wilb Cl~ek CMa~it Gw~, a~ d~rplicaf~ wi~b Tax A~aorJ
~ , ~ ~ 80~ i89 2f~1 ~ ~ ~
~ -
~ ,
~ ~ . ~
Y> +y~.
'-,~~~y,d,~' ~ F'-.~~~~~~~y~- 5h ~3~JM'.~'.~F""'e
_.~S`~~i-.~ ~t za?na_..~"i~-~S'~i~_`T~:.»..:'~~+ ~ _ , _