HomeMy WebLinkAbout0330 ' Decla~ation ot Domicile and Citisenship
~2'?'60
TO THE STATE A(~!D COUNTY TAX ASSESSOR, ' '
51. LUCIE COUNTY, FLORIDA: ~ ~
This is my declaration of Domiciie and Citi=enship in the State of Florida that 1 am filing this day in accordance and
,n conformity with Chapter 222, Section 22~.17, Florida Statutes.
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1 was formerly a legal resident of _ _ - - - ~
(Ciry) (State)
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and 1 resided at TOB SO. FP8ZI~Z~II $t. , However I have changed my domic.ile
` (Street and Number)
!o and am and have been a bona fide resident of the State of Florida since _ __24th _ day of
Januar7 - _ _ 19 ?.2 , and 1 reside at ____Rt.__~~,_Doz 564D, !'t. Pierce, _~'1.. ~
(Street end Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, aduat legal residence and domicile in the State of Ftorida.
(Insert here any pe~tinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, remova! of family to new domicile, purchase of home, etc.)
~siDExcr ~ cxi~xEn ix scgooL
flLEO AMC RFCORpE
ST.~,uC1E COtl~tr FL~.
ROGER POITRAS
JOHB YtDAAIEZ3 JR. age 6 RECORp v[;~F~EQ
COU~~}tG~
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~~xcY a~s aRO~ra a8e e ~~6 I I s9 AN ,lj
YILTOA Z. BROWl~ Jr. ege 10
! ~ ~icH~ aRO~ age ~ 2 222~,60
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~ I FURTHER CERTIFY that 1 will comply with all other requiremenis of s leyal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to retu~n to my former domiUle, and 1 intend remain in FORT ~
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ i
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~ - YR3. J0~ YeDA1~I~3
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~ . _ ~ (Name)
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t;= Rt. ~3, Boz 564B, ~'t. Pieree, ~'l.
_ . s~ ~ (Address) ~
_ _ 33450
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Sworri to and subscribed before me this 26th day of 'T~u~ _ , lq T2 . 1
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ROGER POITRAS ~
Ci CUIT COURT Notary Public .
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By ~J~7k/~i D.C. My Commission expires
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(To b~ ~xecutsd in dupliut~ and ori~ina! ~ilsd wiH~ Cbrk Grwit Court, snd dupliut~ with Tau Assessor.) #
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: So~K ~99 P~~ 329 '
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