HomeMy WebLinkAbout4879 Dectaration of Domicile and Citizenship
"TO THf; STATt: ANU C•ovN~~ti' Tr~X ASSl:SSOR. ;~r~4~g3
St. I,ucie . (•OUNTY, f=LORIDA:
Thi~ i~ my ~lcrlaratiun ot~ Uomirilr an~i Citiz~n~hip in th~~ Stat~ of florida that t am tiling this day in
arcor~f~ncr, and in rantormit~~ with Section '?'.1 Florida S[;itutrs.
1 was fonncrly a le~;a! rrsid~ni oC I?'_~~~Y~l~~_ _ _ _,_,?~?E~jlPSSe3r~-- and 1
(ci~>• ~ (state)
_ _
r~sidcd at '023_ Niller ~ve. , Howcver, 1 havc changed my domicilc to
(Slr~~t anJ Numbrr)
and am aud h:~v~~ brrn a bona fidr r~si~rnt ot thr St~tc of Florida since -2~_-_--- day of
Dec. . I~) 7~. and I reside at 2-78---DSarin~_~~~.-~a--#o--~ea~~
(S~rret and Numbet)
_i - - Ft . ri e rce_ - - • - - - c-~.---I.usi e County. Florida,
- - ~c~~.~? -
a~id this statement is to bc taken as my declar;~tion ot~ citirenship, artuai legal residence and domicile in the State
of Florida.
(Insrr. hrrr anc prrtin.nt f~cts, such as wlr of pruprrty or huci~ert~, ur rrlinyuishmeM of employmrnt at former
domicile, rrmu~al uf family to ne~v domicilr, purchru of humr, rtc.)
~atablis'~ing reeidence
24488~
FIIED ANO kECQ_~iDED ~
ST.IUCIE COUNTT F~A.
ROCER ?O~TRAS
CLERK CfRCUIT COURt
RECORD VERIFIE~.~.~..~
,~w 3 3 39 PN'13 r~
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1 FURTHEK CERTIFY" th~it 1~~~il( r~~~istrr at m~~ toral addrrss «~hen the r~gistratior~ books rcopen, artd
romply with atl other rcquinmrnts c~f a t~,~at rrsident of this St~te.
1 FURTHFR CERTIt=~" tL-at I h:i~•: nc~ int~ntiun to rcturn to m~~ t~orn~~r dvmicile, and ! intrnd to remain in
Ft. Fierce - _ . S~.,Lu~i..e__ . _ ('ounty.
Flurids, pt rman~ ntl> . - « ? _ _ ~
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- • • ~ J. ~ - _
a; . - -
J aeph Paul 3~a jea'
~ r)St' -
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- '~.'t 1 Addre~til
Sworii tci •atid suhs~rih~d hrlc~r~ mc thi. 3 ~l.t~~ ~~f
Januar~~ ..a.t~. t~~ 7:
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~t_~l<--c-y ~Q~?~ ~~-~r
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N ry f'uh6c S[a[r Ilf FIUI1,:! JI l ar_r
~t~~ ('c~mmission r~~irrs J~r,u~r~ 15 ~ 1976
( in hr r~rcu~cJ in Ju~~h..~[r anJ ~~nciu.~l fdad .~ith t'Irrk ('inuit C~~urt. ~nJ JupG:atc w~th Tat .~l,cussori
° Rkzo~
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