HomeMy WebLinkAbout2822 i
Qea~t~, o~ ~~~e ~d c~t~~st~
TO THE STATE AND COUNTY TAX ASSESSOR, `~~8 ~
ST. ZIICIB COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citizenship in the Statc of Fiorida that I am filing this day in
accordance, and in oonformity with Section 222.1 Fiorida Statutes. '
1 was formerly a legal resident of _ l~orth 1[l~n~~e~ter , Indiena and t
(citr) (stats) 'f
resided at Rt~. ~3 . However, I have chan '
cs~«~ ~~a N~m~.~ ged my domicile to ~
and am and have been a bona fide r~sident of the State of Florida since 3~ day of ;
Ya7 , I9 72 , and I reside at 404 Parl~wa~ Drite
csaee~.oa Nwnber~
!~'ort Pierse 3t. Zu~i• County, Florida,
(c~ir)
an@ this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State
of Florida. .
(Insert 6ere aar perlinent facts~ sueh as sak of propertr a b~, a relinquishmeat ot cmplormcnt at torma
domicle, remorsl ot tamii~ to sew domicile. purchase oi Iwms~ etc.) •
TO Ts3TABLISH ~S(~1L HS3IDEI~CS IA 1~ORT PIffitC$, 3T. I,IICI~ CODATY,
~'I,ORIDA.
. s~°tw;~ °c~~
. CIfR~~
~ RCyI CT
~
_ ~ RECORD rER?frEO....,..~
_ ~r ~ 10 s~ AM'11
- ~
~sg8 ~
I FURTHER CERTIFY that I will register at my tocal addr+ess when the registration books reopen, and
comply with all other requirements of a legal resident of this Staie.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in
~'ort Pierce t Zneis
, County,
Florida, petmanently. «'~y~
,,~~11N1Mi1~ ~
C~''' c~''tir RAZ J. CHRISTYAl~
.
c~ d~i~~ pvG,~~~ t~~ Maae) !
.
~
s ='~'.~'ci=~ : 404 Parlcwn~ Dri~e., ~'t. Pier~o, !'ls.~
; ~ _ L~ C: ~
. ~ ~ (Address)
_ ~ s 33450 _
. - : , . :
~ ~ s~ . .
:,~ir~ O'~ii~~~ed before me this 35~.__ day of' -
~ ~ ~.r, .
~ ~~1 y~ ~ Z .
C A.D. 19 2
..~t~r:.r..;..?•t'~ '
xOGER POITRAS, Clerk Ciraui
HZ ~ 6~ Deputy C1erY
(To bs e=ec~te0 iw dYplicsts a~d ori~insl t/ed witw Qak C"rcMit Coart, iwd drpNc~ts witU Tas AueNOr)
~201?~~319 -
. . - _ -
. _ ~
- - ~r _
. . > ~