HomeMy WebLinkAbout0791 Decla~ation o! Domlc~le a~d Citizenship
TO THE STATE AN~ COUNTY TAX ASSESSOR, ~ ~108~j~
51. WCIE COUNTY, FLORI~A:
This is my detla~ation of Oomicile and Gitizenship i~ the Stata ~f F{orida that 1 am filing this day in atcordante and
~n conformity with Chapte~ 222, Section 22?.17, Florids Sta:utes.
1 was formerly a legai resident of ~11 vC? ~i..f _ ~ y~
~ (Ci ) (State)
ti
- r t
and I resided at l!~i~~p ~~.~d~~L~ Howevef 1 have changeci my domic~ile
(Street and Number)
ro and am and have been a bona f+de resident of the State of Flo~ida s~nce -_S ~~C.~
e e h f~_~ day of
5 kr+~s~( L.a~ S p
~ / ~8 M e.c~I 7RCS ~'r4 w e ar~ ~CT l
~/6~' SU Cc ~~l
_ ~Ll~K e - . - 19~ and I reside at ~.~F ~u ~ c _ F/a 3 2 y ~c'U `
(Street and Number)
FORT PIERCE, SAINT LUCIE COUI~lTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual ~egal residence and domiciie in the State of Horida.
(Insert here any pertinent facts, such as sale of proFerty or busineu, or relinquishment of employment
at former domicile, removal of family fo new domicile, purchase of home, etc.)
Bstablie6ina r~sid~ne~
Ftl.EO AND RECOROEO
~ ST.lUC1E COUNT1f FLA.
ROCER POITRAS ~
CIERK CIRCUIT COUR ~
RECORD YERIFIEO
' I7 II az ~M'1 I
- 210862
~ ~
i _ .
f{
I
f ~
f
I FURTHER CERTIFY that I will compty with al) other requirements of a leyal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi~jle, and i intend to remain in FORT
PIERCE, S~LINT LUCIE COUNTY, FIORIDA, permanently_
~ . r
Charle• F. Y:~n~haa ~
(Address)
~
~
Swosn ta and subscribed befQ.e me this 1T~ day of - , 19~.
~~~.~i.+..t,::,;~ ° - T
' ~ } ~ • 'Ji,~i
~~a~~• ~ . Notanr Public
. ~
ey - D.C. My Commission expires
e1 -
:
. ~
- ~ ~ '`J.`
(iq tN . M dupliwf~ and oti~if~al Flsd vitith CIKI[ Urwit Courf, and dupliu» wiM~ Tax A~swr.)
„ aoo~ 1~ ~