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HomeMy WebLinkAbout2283 . . . . . ~ ~ L~eclaration af Dnmicii~ ~nd Citlaen~ttip . ~ ?O TN~ STAYE AND COUNTY TAX ASSESSOR. • S1. WCiE COUNTY, FIORIDA: • . This is my decla~ation of Oomicile and Citizenship In the Sta1e of Fior~da ihal ( em filing thl~ day in actordants and in conformity with Chapter 222, Section 222.17, Florida Statutes. ~ - ~ , s , I was formerly a legal resident of ~I~O ~ , . , _ (City) (State) ~ ~nd 1 rosidad at T[o__~ta!-~-~'~~'~r!`~`v ' Howevor 1 hava cha ed m domi le ~ ~'9 Y ~ . (Street and Number) ~ _ to and am end have been a bona fide tesident of ihe State of florids ai~ce ~ day of : . ' . /~<,~•.st/ ~ - , 19~~, and I ~eside at ~fd ~'""`''~~t'~'~ . ~ ~ (Strest and Number) ~ , l~ORT p1ERCE, SAINT WCl~ CQUNTY, ~LOiRIDA - • ~ and this sta4ement is to be taken as my daclarotion of citixonship, actual legaf residente 8nd domicita in the Stata of Flarlda. ~ ~ - . . {Insort hare any pertinent facts, such as sale of property or business, or relinquishment of employmenf at farmer domidle, remova! of family to new domicite, purchase of home, etcJ ~ . _ ~ . - . ~ . ~ , ~ ' i3~.81.~i ~ . - ~ g • . ~ . _ ~ - ~ . . , - q ~ p9 ~ _ _ ; FILED ANQ R~COftDEO ~ , ` . , . _ ; . r+ • r - . ~N--g~c~a~--T~eco~d_.BOOK ~ . . ~ . . j _ , ` ~ ~ - ~ 1964 DCC 23 AM 10: 33 ' ~ : ~ , - ~ ~ ~ : ~ ' - ~ r ~,~I' ~ ~ ~r: • _ . : ~ . : . RO G ER PO ITRAS, CIERK ~ - 'i'~...~P, ' - . ST. tUCIE COUNT~, fIORIDA r i~ 'r ~ _ . . ,~r, . - : ~ ~ • ' ~ . . . I FURTHER CERTIFY tfiat t wl(1 comply witfi atl other requirem~nts of s leqel re:idsnt of thl~ Stais, - ~ I fURTHER CERTIFY that i hava no intention to retum to my former domi~ile, a~d . i intend to remain in fORT : - ~ i, PiERCE, SAINT LUCtE COUNTY, FI.ORtf3A, permanenlFy.. ~ ~ , ~ , • _ • y to ~ • ~ ' . _ t ~ . ' • ' (Name) ~ ~ , ~tr~!? ~ . , - ~ ~ ~I . . . _ (Address) . ' . • '~±•,1 r,~``,i ~ , ~ ~ • ~ J(/// ~ ~ ~ . " y ~'r i/ ~ • ~ pZ ~ ~ ~~i~/ ~.L7 l ~ Swo ~:~a~c~:ubsulbal bafore ma thi; d~y of 1~ r : •r,~. .~~',•f; . . . ~ ~ : ~1•~'si~i~~~~ e ; t - ~ V ~ • ~1TRA5 . ~ . t: , . . . ~ CIRCUIT C RT Idotary Publk . - 6Y 0.C. My CommiuioPi expf~a , . Ro b~ sx~cvi+~l in ~upp:ah and ai~nsi fil~d wit1~ Ch~it Graeif Court and d+?~llca~h wi~l1 Tax Aa~o~a ~ J ~.R` . 3 ~ , ~ ; ~ ~O~;K i~f~f _ ~ j t - • . • ~ - - _ - - t,,..i - tt : - ~ ~ - ~ . . ~ . ~ . . _