HomeMy WebLinkAbout2960 L ~ .
t
. U~ciar~:tic~~-~ of t~or~~i~i1e tu~a Ci:izen:>tt~p
1 U THE STAI E AND COUNIY TAX ASSE:S,~R. 24983'~ ~
51. IUCIC COUNIY, FIORIDA:
i+
1l~is is my declaration of Oomicilc and Citizc~~ship in thc Statc of Florida that I am filing this day i~ actordanccs and
i'
~n con(ormity with Chapter 222, Seclion ?22.17, Florida Statutes.
1 was formerly a Icya~ resident of ~~NS ~ O/ /~NI~j _ ;
. (Ci:y) (State)
and ! resided at _i~J9 Z ~ Howeve~ 1 have changed my domiGle
($treet and Number) ~
to and am and have been a bona fide resident of Ihe State of Florida sincc . T/,~j~ day of
~ ~
192,~, and I reside ~at 1~ Q~ Sa G A Z
I (Street and Number)
FORt PIERCE, SAINt LUCIE COUNYY, FLORIDA
and this statement is to be taken as my declaration of citizenship, act~al legal residence and domicile in the State of Florida.
qnsert he~e any pertinent racis,. such as sale of property or business, or relinquishment of emptoyment
at former domicile, renwval of family to new domicile, purchase of hame, etc.)
Applying, for Homestead ~ ~ .
Entering children in school :
. Fl~ED ~kc FECV~~EO s
ST.IUCtE ~OUMiY ~A,
ROG~P. ?~ITR~S t
~ CIE~K Ct~tCU1T COURt
• RECOk~ ~E?i=~EO
. • Mrut 16 II i~ AM'73
z49s3~
I FURTHER CERTIFY that I wiN comply with al) other requirements of a(egal resident of this State.
i FURTHER CERTIFY that I have no intenfion to return to my former domi~ile, and 1 intend to remain in FORT
P(ERCE, SAINT LUCIE COUNTY, fLORIDA, permanentiy. "
• / ~ .
c; U t T C.(/
j 4.yvUi'.~'• ' . _ . (Name)
~ ~ ~
_ ~'R , c;• ~ ,
' `+.~J._ ~
y' o ; ~ x ~ ,
, =~ti~~t±::' J{ n; ? O / ~ ..-c~
! y~ ^
J }i . -
~
. •~':~t
~ ~ ~ e: _ (Ad ress)
.'4 ~~.v,,: -
. ' =
. ; ~
;•-,Swd~n tt~ and sub:c: ibed before me this day of _ ~ ~q2_Z.
~ ,
ROGER POITRQS
CIERK CIRCUIT COU Notary Public
:
.
QY - _ O.C_ My Commission expires -
(To be execuled ~in dupficate and •na) filed wilh ~ I~erk Circuit Court, and duplicato with Tax Assossor.)
w dO~X 211 rNCf ~V~
- . _ _ ~
~ - - ~
~ . . -
. . . ..s[.:ss