HomeMy WebLinkAbout0538 •
, Decl~ratton r~t Do~nicile and ~ltiz~~strip
. TO THE STATE RN~ COUNTY T~1X ASSESSOR, • :~.e~~~~~
ST, WCIE COUNTY, fIORiDA:
this is my deelaration of Domicila and Cititenship tn tha Stata uf Florida that I am filing thit day in ~aordanco And
in conformity witf? Chapter 222~ Settlon 222.i7, Floricla Statutes. ~ .
1 was formarly a legal resident of _.__~~Q~d~ ~'Q~~b ~ ~an~d~
(City) (~tate?
and i ~eaidad at 4? Rena~~d , However 1 have chenfled my damir~le
(Straet end Number) ~
iath
. ro and arn and have bean a bona fide resident of the State of Fforida stnco day of
~ November
, 19 64, and I reside et 729 $ South I~d_xiverl2r~y~
. (Street end Nurr~ber) ' ~
fORT ~tERCE, SAINT iUC1E COUNTY, RORIDA . .
and this statement is to be taken as my declaration of citizenship, actual legal reaide~ce and domicile in the Stats of Flortda.
(Insert hera any pertlnent facts, such as salo of property or bustneas, or reltnquishment of employment
at former domicile, ~emoval of family to new domicil~, purchass of home, etc.)
soA Bnter~ng Ju~ior High School ~.;;;~~:3ir~;l;~~~_~; J
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IN.._.~!#ft~ta ST
i AN 9~ 47 _
196~~N01~ 2 . - .
, ROGER P01~fR~ F~i0ei0 ~
St. tUCIE COUt1t . . _
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~ 1 FURTHER C6RTIFY thaf i wiil oom}~ly with all other ~equtr~msnts of a IsQat ~estdent of thu Stata `
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! fURTHER CERTIFY that I hsve no intentior~ to return to my former domivl~, and I intond to rsmain in EORT
PiHtCE, SA~Nt WCIE COUN'tY, FLORIDA, permanently. ~ .
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Swo~n to and subK~ibod bsfore me this ~1 day of NOVembt~' ~q 64, .
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ROaER l~piTltAS ~ ~ + ~ ~ ~
CfRC COURT ~ Notary Pubik . .
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# D.C. ~ My Commistion axpiros
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(To ~ aa~arrod i~ d~piksl~s ~ei Ki~Ma! RWd w1l~ ~ G~f1 Co~wt, and d~pliea~e wi1f~ Tax A~r.~
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