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HomeMy WebLinkAbout1211 ~ ' ~ ~ L~~cl~ratlo~ ot R~~mi~ile a~ntl Citl~cer~shlp , : TD TH~ STASE AND COtltdTY TAX ASSES~OR, ~ ~ Sf. lt1CIE COUNIY. FIURiDA: ~ ~ . ; . i- : j This is my declaratian of Oomicile a~d Citiaenahip in the State of Florida that i am filinq thi: dey tn acoordartce aexl ~ ~ in oonformity wiih Chapte~ 2~Z, Secilon ~22.1 y, floclda Statutes. . - ' ~ ' Mar land j + ~ I was formerly ~ legal residant of Owin~s M~i l~,s . Y i ; ~ (Ciry) (Staro) 1 ~ , . . . i and 1 tasided at 11 P~easent Hi11 Ros~sl Flvwevsr 1 have changed my domivle , ~ ' - ' . (~treat and Numt~er) ' to a~d am end have been s bona fide resident of tt~e Sta~t@ of Flarida :ince 3 r~ ' day of 'j , . . . : O~tQb~r , i9 6~, end ~ ~e:tde at Rt ~$ox 2025 IndrioKoad ~ . (Stroet and Numbor) ' ~ . ~ . PORT ~ldtCE, SAlNT WClE COUNTY, FLORIDA ~ , . . i • ~ }'j ` and this stAtanreent i: to be taken as my deciatetion of citizenship, attual legai residanc~ and dom{cile in tta Staro of Horld~. ~ (Insert hero any pertinent facis, such aa s~le of Qrop~rty cr buaines:, or relinquishment ot emplayment ` ~ . at former domicile, removal of family to new domicile, purchase of home, etc.) . . ~ . ' ~ ' . ~r ,t • " • : ~ 13Z2.L1~ ~ . : : Bstablisl~~ng resid~ncq . F~~ A t ~ • ~ fl ECD ~~p , . = f a - - . ' . jN ~ . ~ _ 4 ~ ~ ~ r9s ~OQK . . ~ - ~ : - . ~ ; QEC~ ~j~2: 31 _ . ~ ~ , ~~ls ~ R ~ :~`~~4,,,~ :....,,,c~~ ~.,i ~ ~ ' ,ST.~ttGlCi~ POITRAS, CLfRK ~ , .,..3f • ' . • t ~r COUNt1'~ FLORID, - ~1 ~ ~ G'~, • • r . ~~~q' AS~ ~ : . ~ w a ~j('4t*~t ~ . , ' s ~ ~ , t :y ,•r , : ' ~ ~ ' ~ ~ ~ ~i ~ . . ~ . - . . ~ ~ - K-*t.,... . . . . ~ ~ ~ ~ : "o~ ~ ~,a,a . • . . • . . - - - - - - _ ~ . . . - - _ - - - - - - , . ~ ~ ~ - _ - - - _ ~ ~ . ~ . - - - . ~ ~ . _ - . ~ ~ . . ~ ~ . _ ` 1 FURTHER CfRTIFY that 1 wili aomply witfi aU othor roqutr~nh of e tpa! tesk#ent of thts Steh. ~ . : ~ . ' ! FURl'HER CERTlFY that i hava no intentton to ratum to my former domi~ile, and i intend to romaln ~tn FORT : ~ PIERCE, SAINT LUCIE CI~UNTY, FLORIDA, permanentty. ~ ~ t , - . ~ c i. • ~ ~~~.~~1 . • . . w ~ ~ - . . ~ j ~i . O " Il~~ ~ . . " . ~r . . ~ . ~ . 4f } . q1 ~ i'1 k • - ~ ~i!e!'~~ ~ ~~i • r ' ~ ~ ~ 'i~ , # ; ~ ~..r? _ ' . Seth ~°.~~ight _ ~ ~ _ ~.ta~ ~ ' 1 ~ ~ . . . i~! 'i,. ' M - ` . . t , O~ (A.~C~feit) 3 ~ , _ . ; ~ t ~ ~ _ - ~ Svmc~.. o and :ubxribed befar~ me thla ~ 3rd day ~ ,~Uecembtr . 19 ~ 64 : ~ : . . - . . ~ . : ~ , . ~ ~ ROG#R tO1TRAS . • - ~ " ~ CIRC CONRT - ~ ~ : , : Notary PuWk . , _ . ` ~-~t.C,. . ~ - : . ~ ' _ _ . _ Q.C. : Mr ~'som~ntsslon expi . ~ ' , . 001( P14CCE ~ _ ~ ~ . . - ~ . . t, ~ _ ~ . _ . Ro b..uc.wl~a ~A du~CM. aua o~i~Mal fN.a wid~ a«k c~a~N cow~t, a~a a~ia~1. wi~l~ t~oc AM.«.r.~ . - _ ~ . - - . _ _ > _ . - - _ ~ 5 uyv~ f