HomeMy WebLinkAbout2927 O~al~uratlon M Oomlall~ and CitlsMShlp
TO THE STATE AND COUNTY TAX ASSESSQR,
Sl. tllClE ~OUNTY, FtOR1~A:
This is my d~cl~r~tion of Oomicil~ ~nd CitisMthip in th~ Sut~ of Flaid~ th~t 1~m filin~ fhi• day in acaordano~ ~~d
~n conformity with Chapl~r 222, Saciion 222.17, ~lorida St~tut~s. •
I wss formerly a Ipe! reiid~t of ~ ~
Ki~Y~ . (St~h)
snd 1 resided at ---1.~~ ~~--~-T-~-.~-s~~ G'C • . However I hav
e tharp~d my domiJ~e
(Strett and Numbe~)
ro and am and have bean e bo~a fide resident of the Sta» of Florida :i~os day of
. 19 r~ , and 1 reside at l•s 6 ~-•c.~~~-•~-L .
(5tre~t a~d Numb~r) ~
FORT N~CE, SAINT LUCIE C4UNTY, RORiDA
and this statement is tQ be taken as my dedaration of citizenship, actuai te~aal r~idenos and domidle in th~ State of Florida.
(Inser~ here any peninent facts, such es sale of property or butiness, or relinquishment of employment
at former domicile, remova! of family to new domicile, purchase of home, etc.)
~ 204 _
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~ucrE cou~~irR~~.
CLERK6C
RCUIT QOy~T
~ RECORC VERIFIED,..~„~~
fEe 3 f1 li PM't~
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~ 1 RJRTHER CERTIFlf that I will oomply wHfi all other rsquirem~nfs of a Is~a) rssidsnt of thi: Stste.
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~ 1 FURTHER CERTIfY ti~at I have no intention to return to my former domicjle, and 1 intend to remain in FORT
~ PiERCE, SAINT lUCIE COUNTY, FLORIDA, permanently.
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A, b• ~nd suburibed before me th~s day of ~ 92'~
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~ ROGER ?OtTRAs
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= CiRCWT C Not~ry Public
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. BY ~.C. My Commitsion expi~s
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