HomeMy WebLinkAbout2533 D~ecl~rat:on of ~~micii~ an~ ~i:~z;:.::::j:~
IO THE STATE A(v0 COUNTY TAX ASS~SSOR,
Sl. IUCiE COUNTY, FlOR1~A- ~~~~~3
Th~s ~s my declaration of Domiuie and Citizenship in the 5ta;e of Flori~a that 1 am filing this day in accordance a~d
~n conformity w~th Chaprer 222, Section 222.17, Florida Statutes.
I was forme~ly a legal resident of ~~O!v /~(,lJ vl.'I~S ~ L/ .
(City) (State)
oC~
2_~g~1~~~ S~ However I have changecf my domiCi~e
~~~d I resided at _
(Street and Number)
~o and am a~d have been a bona fide resident of th~ State of Florida since _~~L-"~ _ day ot
--1~1~~ - - - 19~f, a~d I reside at 7U ~T ,3~/~~_~l/~~.1 T
(Street a~d Number)
rORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be raken as my declaration of citizenship, actual legal residence and domic~le in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employrnent
at former domicila, removal of fami:y ta new domicile, purchase of home, etc.)
I have moved here t~ live with my brother, Robert I,ovell
~vho is a pernsnent resicent of this County and livea~at
Box 570, Route 3 ~range Avenue Estenaion, Ft. ~'ierce, Fla.
fILEO ~?ND pECOR0E0 ~
~T. LiiC1E GOUMTI fU.
ROGER POIMAS ~
CIERK CIRCtlIT COURt ~
NECONO YER~ftEO~ ~
f
Ha~ ~I 9 04 ~M *71
~
2181'73
~ -
L
1 FURTHER CERTIFY that 1 will comply with a:. other requirerr~ents of a legal resicient of this State.
Y :
' 1 FURTHER CFRTiFY that 1 have no inientic,n to return to iny former domiu~e, and f intend to remain in FORT
~ ~~~~CE, SAINT tIiCIE COUNTY, FIORlDA, permanently.
~ r .
- ~(Na~::e) Gary Dover
- - f
_ ~ . . (Add: ess)
~ 4th Novemb~r 71 ~
- Swom ta atld 3ubscribed before me th~s day of _ , 19 .
_ ~,ROCsEJE•~OdTRAS - -
~ CL~tK +~1RCU1T COURT ~ Nasary Pub:ic ~
~ _
, - - ;
} f~"` ~ , i :
~ D.C. My Commission expires #
, ,
a
= (7o ba oxecuted in dupticate and original fited with Gerk Grcuit Court, and duplicate wirh Tax Assaswr.) f
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- : : ~ ' aooK 196 PaCE25~9 ~
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