HomeMy WebLinkAbout0940
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. Deci~r~4i~n ot Aomlcii~ a~t~ ~itizens~ip
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TO TNE SYATE AND COUNTY TAX ASSESSOR, ~
5T. IUCIE COUNTY, FIORIDA: ~ •
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This is my decla~ation of domicile and Citi~enship in the State of Florida ihat I am fiting this day in accordante and ~
In conformity with Chapter 222, Section 222.17, Florida Statutes. F
I was formerl a le ai resident of YOnkez$ N~"''
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(City) ,
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~nd I roslded at 27 Glenwaoci A~g., _ . Nov~ever I have changcd my domicJlo ~
(Strest and Number) ~
21st ~ ~ ~
to and am and have been a bona fide ~esident of the State of Florida since ~ day of j:
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~ January ~ ~q 6~,nd ~ restde at 1].1 btain STreet~ - W~?
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(Street and Number) !
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~ fORT PIERCE, SAiNT LUCIE COUNtY, FLORIDA .
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and this statement is to be taken as my detiaration of citizenship, actual legal residence and domicila in the State of Florlda.
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~ (Insert here any pertinent facts, such as sale of property or business, or telinquishment of amployment
~ at former domicile, removal of famify to new domicile, purci~ase of home, etc.)
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' Bstablishing residency-
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~ Will a 1 for homestead after the first of the ear~• ~
pp v , y 13105~
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800K
~:~~r~'~s cr'~-.. . ~ .
,,,,..N.... . 1964 NOY 27 PM 3. 4S
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~ = q ~ : ROGER POITRAS. CIERK
i . : ~ _ ~a~~~y' : : ST. IUCiE COUNTY, FLORIO~
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. ~ i FURTHER CERTIFY tf~at I will comply with atl other requiremenn of ~ leyai restdant ~f thia State.
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I FURTHER CERTIFY that 1 have no intention to return to my former domic~le, and t intend to remaln in FORT
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P1EitCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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! ••.,~~~n t~[~~•subscribed betara me 4hia ~7th day of NaV. . ~
~ •~.....~•~MN~ ,
itOGER POITRAS
l,ERK CIRCU COURT Notary Pubitc .
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' D.C. My Cammi:s(on exp
~ . ~ BoR~ 104 ~a~E3~0
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° : (To b~ ~xscvt~d in dupfiah and ort~inal filed wkh Clsrk Ctrcuk Court, and duplteat~ wifh Tax A~or.1
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