HomeMy WebLinkAbout2529 _ . . . . . . _ . _ ;
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~ i~~clara~t~~n tat Dor~i~if~ and Citizens~tip ~ ~
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~ TE AN~ COUNTY TAX ASSESSOR,
~ TO THE 5YA ~
~ Sl. WCI~ CUUPVTY, FIORIDA: ' • . ~
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~ This is my declaration of Uonniciie and ~itizenship in the Stat~ of ~lorida that i am filing ihis dey in ac~cordance and
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k in conformity with Chapter 222, Section 222,17, Florida Statutos. '
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S 1 was formerly a legal residsnt of _
; ~ciry) (Staro)
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I ' end ! rosided at w°5^ ~ . However 1 have changed my domicJle ,=i~
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! to and am and have been a bona ffde r~stdent af the Stato of Florida since Y
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, 19 , and I reside at ~
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~ FORT PIERCE, SAINT WCiE COUNTY, FLORIDA . ' •
and this ataterr~ent ts to be taken as my declaration of ctttzenship, actual legal residence and domiclie In the 9tote of Florlda.
~ (Inse~t here any pertinent facts, sueh as sale of property o~ business, or relinqutshment of employmont ~ ~
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~ ' at farmer domicile, remova) of family to new domicile, ~urchaso of home, etc.) ~
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~ FiIED AND REC4ROE0 . . . , ,
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- . ~ IN ~rj'~ '
~ ~ : ~ . ~ 1964 DEC 29 Pl~ 2: I9 ,r~:~ • . F:w
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; ROGER PUITRAS. CIERK ~
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- ~ ~ . , . St. L~ClE Cfl~1NIY. ~i~ftIDA . . .
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~ i FURTHfR CfRTIFY that I will compiy with all otfier requiromentt of e(egsi resident of this State.
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- 1 FURTHER CERTIFY that I have ~o inteMion io retum t~ my forme~ domf~ile, and I intend to ~emaln in FORT -
~ ' PIERCE, SAINT LUCIE COUNTY, FlORIDA, permanently. ,
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Swom to and :ubxribe~d befors me thi: day of 19 :
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` R rO1TRAS .
k~' . ' CIRCUIT~Q URT Nota Pubitc . ~
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€ . - `r, gy ~ D.C. My Commission expires .
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t (To b~ pc~cvtod in .dvpNut~ and o~nil Al~d whh Cl~rk Circuh Cour?, a~d duplksh wilh Tsx A~«~a .
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