The URL can be used to link to this page

Home My WebLink About0039 . . ' ~ ~eclara4ior+ ot Qomi~l~e and Citizenship ;j,~Q~~Q TO THE STA`~E AND COtlNTt TAX ASSESSt)R, , t S1. WCIE COUNTY, FIORIDA: _ ; F 1 Thi: is my deciaration of domicile and ~~tixenship in the State~of FIo~Ids that 1 am flling ihis dey in aaordence and ~ 1~ conformity with ~hapter 222, Seclion 222.17, FIAr1da Statub:. ~ 3 ~ ~ 7~i ' ~ ~ ~ ' ' ~v~m.~i ~ i wai ~ormerly a legat resident of - ~ ~ (Ciry) ate) •~d 1 ~a:lded at , . Nowav~r 1 h~va chenqed my domWle ~ (Stre6t and Number) . t~o and am and hav~ bean a bon~ fido rosident of tha Stats of ~la~ids atr~ta ~ day of . ~j~~ (~'J ~D ~~[~t~i ~ ~Ey~!'fi-~s`-- , , 19 and i reside at (Street a?9d Numbet) f ~ . f~MT RlERCE, ~AINT LUCIE COUNTY, ROitiaA . ar?d thia statement is to be taken a: my declarotion of citizanship, actuai le~ai restdence and domicile In tha Steb of Florida. . ~ . (Insert here any pertinent facts, such as sale of prape?ty or busines:, w relinqulahment o~ ~mpit~yment k at former domicile, removal of family to na~w domicile, purcha~ of home, etc,) ~ ' , . 4 ~ ~ ; • ~,t.[.i % ~ t,i,~,~,~ /~~-.~rrci""~ ~ os5o _ , . . ~ ~~E~ . , . F ~ootc . _ , . ~~W ~ . , . tN.-----_ . - _ ,1 , r - - 4 N0V ~ 2 pM 10: 06 - o~ ,,.H. ~+o~ <<, ; 95 `-=5. 1 . ~ ; . ~ ,y.:~ ~ K , : : R~~ER Ppt~I RAS. CI..R A • _ . . ~ ~ ~ ~ pUt~1`i• F~ ~ z ~ ~ i ~ f . S ~~CIE C ~ - " ~ ~ ~ ~~'i ~ : ~ . . . ~ ~ . ~ . ` • ~ ~ ~ir • . r ~ ~4! , . _ . _ i 1: , ~ . ~ . ~~~''~i~~u~~~~~~~~'' J~, . ~ . . . - ' ~,."~.:.m.+' I : • . • 1 FUR'TIi~R Cf~tTIFY that 1 will oampty with ail ot9~er requlrarant~ of a.le~ai raic~nt of thi: StaM, t FtJRTHER.~RY~FY that 1 hAVe no intentlon to ~eturn to my former domlc~le, snd i intand to romein in F4RT 1ff~~~1~~~~~//~ . . . . . ~ . WERC~~~$r°?l~~ t~C~~~~UN71~, FLORIOA, permenently. . . : 1.~'~. _ .f,.-•,,~~ ~ - • - -.,E ;f t+~ • ~ . ` - . i = GC. ~ ~ 1 ~ ~ : C 1f° . _ £ r ~ ~ ~ _ (Name) , ~ i - ~ ~ ,r, t ' . ~ ~ ~ ' . ':+.~1, , 1 ~ ' - ' (~1~~e3i) . _ - ' - r . - Sworn to and wbscriberi beforf ine thtt . - day of ~ 19.~..-. -rY ~ . . . . ~ . . • • . . . ~ ~ - - . ~ _ ~ ~ . . . - . . ' - . . ' . . . . . ~ . . . . . . f'. ~ - . ' . ~ " ~r_ . ~ _ ~ . . . . . _ . ~ ~ ~ ~ . . _ . _ - - ° ' ~ , ~IRCWT C . - , . _ ~iry Publk • - i . . . ~ . ~ . ~ ~ . . ~ ~ . ~ . ~ . . , ~ . . . . <:r dfl D.C. ~ ~ My CortKntubn ucptns ~ _ . 86~~ A ~ ~ ' ~T. bs .x~a~! la d~plk.l. sAd .rt~inai Rl.a wilh csalc cina~if c.~w+, aad ~1. wilb T.x Aww~era ; : _ , . _