HomeMy WebLinkAbout2735 2t14U38
~Cla~atlon ot Oo~niail~ a~d Cltls~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FlORIOA:
This is my decleration of Oomicil• and Citisenship i~ th~ St~t~ of Florid~ that I~m filinq ihis day in acnord~no~ ~nd
confo~mity with Chapte~ 222, Section 224.17. Florid~ St~tut~:.
1 was formerly a lepel resident of _~anidl~~..-_ P~~~s te e- _
° (City) (Sfs»)
and 1 resided at {~~s=~~ ~~:v~ However 1 have chanyed my domicjle
(Str~et and Number)
to and am and hsve been a bona fide resident of the State of Florida sinoe ~ y- day of
. 19.~L, and 1 reside at El ~w~c~~
(Street and Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be takan as my declarotion of citizenship, actual legal ~esidence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sate of propery or business, or relinquishment of employment
at fo~mer domicile, removal of family to new domicile, purthase of home, ett.)
~1,~ ~r~t C~~a: l-y,v.v ~~aRr~ ~ A~~ ~ , C ~w.
204038
t lE0 AND RECQ~~
i~,111C1E GONN~Y
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REC4110 YEp?tiED
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I FURTHER CERTIFY that I will comply with all other requiremenis of a IeQal resident of this Staro.
I FURTHER CERTIFY that i have no intention to retum to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~,[6Q~~" ,8. W~qr'foll
~ ~ Q ~ . l ~
(Name)
` ?o~ E/ ~.4.?c~Go ~~R_
~
~ (Address)
~ ~
~ Swom to and suburibed before me this day of , 19
~
~ R~~` e~~~: u;i,,~~
. ~
~ ~ ~ ~G~ Notary Public
` • .
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~ By ~ ~ _ D.C. My Commiuion expires
_ i ; ~ ~~~'Y;,~~~~ r~ Z v :
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Re I~~ ~~i ~ ,~,dV~iwt~ and ori~inal fil~d wiN~ C{Klc qra+if Caret, aed dvplieah wkl~ Tax At~a
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~ ~~f~ ~ ~ z 1 F.? 1
S~ , 800K 1U9
~ No. 13 r,~/~rl{tt1111~~~~~
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