HomeMy WebLinkAbout2836 2t l~t)~~
O~aluatlo~ of Oo~nlall~ aM! Cltis~nship
TO TNE STI?TE ANO COUNTY T~?X ASSESSOR.
S1. UlC1E COUNTY, FLORI~A: ,
This i: my declaration of Oomicil• ~r~d ~itiz~nship in tM St~t~ of Florid~ th~t 1•m filinq thit dsy in scoord~nos and
in aonformity with Chapter 224. Ssc~ion 222.17. Floride Statutts.
1 was formerly s legal rosidont of 'Y~1~G N~ ~?J ~ F~~~~~-
(C~y) (St~ts)
and 1 resided at °1-1~ ~ 0. ~ . However 1 have chan~ed my domi~3ie
(Street a~d Numbe~) _
to and am and have been a bona fide ~esident of the Stats of Florida sinos ~ day of
1` , 19 -`t b and 1 reside at O a• ~ d a.5~
(Sheet and Number)
FORT PIERCE, SAlNT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residente and domitile in the State of Horida.
(Insert here any pertinent fetts, suth as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to naw domicile, purchase of home, ett.)
fILED lE COUM
Y FLA.
. fT. j~~~it POItQAS ,
CI.ERR C?RCUIT C411~~ •
IlEC0~0 VERIf IEO • ~N,11
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i 2Q4099
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~ I FURTHER CERTIFY that I will comply with al) other raquirements of a Isya) resident of fhis State.
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I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 infend to remain in FORT
~ PIERCE, SAtpl~~'LUCIE_COUNTY, FLORIDA, pe~manentfy.
``,1,~~~~~~a~~~!iin~i~~, 3USAlq I,. CSOATOS
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~ Swom to and subscribed before me this day of , 19Z. ~
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~ ROGER POITRAS
~ _ CLERK CIRCUiT COURT Notary Publit
~ ~ ~ ~
~ By D.C. My Commiuion expires
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(To b~ ~x~cvhd In dupliuN and ori~inal fil~d wilb C{~~k Cinvit CarK, ind dvpijtat~ wi~ Tax A~rJ
BOOK
~ ° R ~89 282.7.
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