HomeMy WebLinkAbout1989 V
D~clar.zf:on ot Domieil~: G.~~ ~~~::z~r.;;:::~3
i Hi: ~TATC A\D CO:;I~ i Y TAX A~SESSOR,
~l . IUC;E C~:UNTY, r"LORiDA: ~ ~ `
Tiiis ~s my de~:arar.~n ot ~~m~ute anci C;t~z~nsh.p ~n ;hr State o; F.or;do that ? ~m t~;~ng tn~s day +n accordance ar,d
n coniorm,sy w~th Chapter 222, Secr~o~ 222.17, r'lor~da Statutes.
i was forme~~y a iegal resident of . ~~~t@?'Yllet__ _ _~~~~~$1L______
(City'j (State)
and t resided at Ger'-eY'al ~e11Vet'y Howzver i have changed my domi~ile '
(Street and Numoer)
'o and am and have be~n a bana iide resicient of the State of Fiorida s+nce ~ ~~6th . _ day of
i October , 1971 , and i reside ar ___North 21at atreet
, . _ - - - _ . -
{Sireet and Number)
~ORT PIERCE, SAIidT LUCIE COUNTY, fIORlDA
i
and th~s statement ~s to be taken as my deciarat~on of c~sizensh~p, actuai :eca! residente and comiciie in ihe State of Florida.
' (tnsert here any p~rtfnens facis, such as sa~e of properiy or bus:ness, or re:inquishment of emp;oyment
; at former domicile, removai of fami~y to new domicile, purchose oT home, estJ
s
,
~
} ~tat~a Enterin~ 2 children ~r, achool
a ~
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f LEO AMD 11fC , ~
_ f ~ Ul~tE C I~
; ~E
OCER P~all~ t
R~ CIRCWT Op~T , ~
_ RfEORp Y[RIf1E0 ' ~ ,
Qcj tl IZ s~ PM'll
- i FURTHE2 CE2T{rY ihat I wili comply witn ai! other require;nen;s of a~eyal res;dent of this S;ate.
I"r~R ~ HE~ CER ~ i~Y that i have no intent~o:
~ to retum to 'my io: mer dorn;~~:e, a:,d i inter,d to remain i~ FORT
r~CRCE, SAINT IUCIE CCv~i~Y, F~O+~iDA, permanent~y.
. ^ ,
- • ~ /
- ~~=Z~' ~ -
~Name't'~~~
~ i
~?everley kn~: '"aylor
- (A~'c: essi
Swom to ar,a s:;'~scr:bed oeiare me ;n~s Cay of _~~pr,g..~ _ ;9__ ~_1
' ~;C~GER POITRAS
CIY"c2K Cl~CUIT~OUR7 - \o;.,ry ~J:li:c -
"-<'lu--~ ://c`t ~i-~~
° 3Y~
~c 17.~_ Pr~~y C'vm~~~~SS:Jn C.a~~fc5 - -
(to be oxcseuted in duplieosu and originai fa~eci wirti Clerk Gircuit Court, and dupiic~tc w~sh 7ax Assassor.)
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