HomeMy WebLinkAbout2202 Declaration of Domicile and Citizenship
TO THE STATE ANU COUNTY TAX ASSE.SSOR. 234406
St. Lucie CUUNTY, FLORIDA:
This is my derl~ration ot' Domicile and Citizc~}ship in the State of Florida that 1 am tiling this day in
accordancc and in contormit with Section ??2.17, Florida Statutes. ~
. Y
Scranton Penn ~
I was formeriy a irgal residtnt of - and I
~c~~r) (s~a~z>
resided at 905 _Froude Ave. _ . However, 1 have changed my domicile to
(Strcet and Number) 't
and am and have txen a bona fide resident of the State of Florida since _ 15t~ _ day ot' ~
Jul~_ , ~9__?? , and 1 residr at -_?609 So 26th street
(Street and Numbe~)
Ft. Pierce St. Lucie County, Florida,
- ~(c~~y)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inseri here any pertinent facts, such u sale of Qroperty or business, or telinquithment ot emploYment at former
domicile, removal ot family to new domicile, purchase ot hame, etc.) _
Eetr~bliahin~ re~idence 234406
Will enter Barry in the Iiigh School
;~,LI~ICIE COUMIY fl~.
ROCER POItRAB
OLEI~K CtRCUt? COURT
IItCORO V[FtIFIEC.~.~~
~ 1 IZ vz PM'~Z
_ ~
~
~
I
I
i
~ ;
~
1 FURTHER CERTIFY th:~t 1 will register at my toca! address when the registration books reopen. and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have ~ZO intention to return to my former domicile, and 1 intend to remain in
Ft. Pierce __St. I,ucie County,
Florida, permanently.
r ..r~:~lrq~~~i
. ' ,i~~ ~l
. (Name) .
' ~ _ Ros e Gabello ~roczko~rski (biroz )
' ~ : - -
; - ti ~ ~ - ~~aa~eu?
. . • . ? .
~ .
_
~$~vorq t0 att~!~bscribed before me this _ l~t - Jay of
;
"'p;uaiast------- A.D. 19??___.
- ~-c~l ~ -
ry Public Sta1 E7urida at Large
My Commission expires <<-w ~~i~!1°-_
(To ~fe executed in Juplicate and onginrt (iled with Clerk Citcuit Court, and duplicate with Tax Assessor)
~i1Cf~~
-
~ ; ; :Y3 ~
~A , s ~~:.~s~-
~
~~~~,~`r . ~
:
. s?~i~_ .