HomeMy WebLinkAbout0831 Declaration ot Oomicile and Cltize~nshjp
2t:~810
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida thst I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
Poiti o •v.~? G p~, ~
1 was fo~merly a legal ~esident of _ -
(City) (State)
and I resided at z~!
y_7 ~ x~v AL ~ Av ~,,,,e„er I have changed my domiG~e
(Street and Number)
iti
to and am and have beeo a bona fide resident of the State of Florida since day of
i4_v C~ v_S T ~9
~
9, and I reside at /05 Mp Pl,l~ A.r r ___A
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former d~?nicile, removal of family to new domicile, purchase of home, etc.)
STA 2T~= t~ G~+ P ~ 0 y M L° w/ 1- S~v i Nr2~?./ (3c'~ L 7~L _ t?'dL . G O.
t~n/ rqu4- ~8, /96!`'
204810
F ~ED ayC,aEC0~0E0
S~. ROG~GRVPO
~RAS`A.
CIEttK C~RGUIT COURT
IIECORt? ~fR~flfO~.-=~
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~ 1 FURTHER CERTIFY that I wiil comply with all other requirements of a leyal resident of this State.
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT
~ PIERCE, SAWT LUCIE COUNTY, FIORIDA, permane~tly.
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~ : ,.J~ (Name)Ge7e81 I,.B8Z8A
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~ ~~~"'•~~to~~~~.st~sscribed before me this day of _ , 19 7~ .
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~ ROGER POITR/?5
~ CIRCUiT COURT Notary Public
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~s By a~-~'`'t' D.C. My Commission expires
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~ o b~ ~x~cut~d in du ~cah and ori lnal fiiled witl~ Garlc Grcuit Court, and du Iuh with Tax AsMStor.)
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~ aooK 190 ~28
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