HomeMy WebLinkAbout1796 Decla~ation ot Do~nici~e a~d Citizenshi~
TO THE STATE AND COUNTY TAX ASSESSt7R,
2135'7 :
Sl. LUCIE COUNTY, FIORIDA
Th~s ~s ~»y deciarahon of Don~~ule and Cihzensh~p ~n the Stare of Flor~da that 1 am hl~ng th~s day m accordance and
~n conformity with Chapter 22?, Section 222.17, Flo~ida Stasutes
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1 was formerly a legal res~dent of ~ . _
(C~ty) (State)
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and I res~ded at s ~
.~L1L ?t.e~ However 1 have changed my domicjle
(Street and Number)
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+o and a~n and have been a bona fide resident of the State of Florida s~~ce ~ day of
1 ~ / " . ~UK ~ i
, 19_ and I reside at '~fJ / ~-e
($treet and Number) '
FORT PI~RCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of c~tizensh~p, actual legal residence and dom~cile in the State of Flarida.
(Insect here any pertinent facts, such as safe of property or bus~ness, or rel~nquishment of employment
at former dcmicile, removal of family to new domicile, purchase of home, etc.) ~
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_ t'~t~LC4' ~ nte-.~ ' ~ ~
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f~~EO,?~a R:coR~~
5T, tNCiE CflYNTY ~
RGCEk PO~TRAS ~
' CLERII C~~CUIT COWtt
' RECOR~J vEP,IFIEO..~.~..
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~ Auc 10 4 0o PH'T I
2135'75
~ I FURTHER CERTIFY that I will comPly with all other requirements of a iegal resident of this State.
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t FURTHER CERTIFY that I_have no intention to retum to my former domi~ile, and 1 intend to remain in FORT i
~IERCE, SAINT IUCIE COUNTY, FIORIDA, permanently. r
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~ (Name) C /Pk vc.s ~
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~ Swom to and subscr~bed before me this _ day of C~lLG~v«^_--~ 19~
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~ ROGER POITRAS - - - -
~ CLERK ClRCU11•~Ol~T ~ Notary Public
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~ Y ~-r~-j~ O.C_ My Commission exp~res ____r________
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# (To b~ execvt~d in duplicsM and ori~insl filed with CI~?I~c Grcuit Cou~f, and duplicaM with Tas Ats~ssor.)
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