HomeMy WebLinkAbout2624 ' J
De~l~ration ot Domtcfle ar~d ~itisenshi~ -~-~2~1.:~
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~ TO THE STATE AND COUNTY TAX ASSESS~R, • ~
ST. LUCIE COUNTY, FlORiOA: ~
This is my declaration of Oomicile and Citlzenship in the Steta of Florida that. l am fill~g this day In accardance and
~ in conFormity with Chnpte~ 222, Section 222.17~ Floride Statutes.
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~ ! was formerly a fegal resident of ~nt~~~~~4 _._$lnr id~,
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Rt. 2 Bx 1298 . Wowever I~have changed my domic~la ~
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~ b and am and have been a bona fide resident of the State cf Florida sinca 17th day of
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~ _~pr i 1 , 1921^, and i reside at ~~~-r~ v~ a
(Street and Pd~mbe~)
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~ ~ FART PIE~tCE, SAINT LUCiE COUNYY~ fl.GRIDA ~ ~ a
i and this statement is to be taken as my deciarotion of cltizenship, actual legal ~osidenca and domicile in the State of Floride. `
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i (Insert hera any pertinent facts, such as sale of proparty or business, or relinquishm$nt of emptoymant f
; at former damicile, removat o# family to new dornicile, purchasa of home, etc.) ~
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~ Bntering one C1) child iA Schpol
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~'f•' ~•,••.r?-~ J~.3201~ :
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' ~ ~ ~ ~ FlIEQ AP~D RECO DED
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~ ; ~ ~ IN...~E! t~00fC -
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i • ~ 1964 DEC 30 ~ AM I I : 04 - .
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~ . ROGER POITRAS, CIERK ' ,
_ ST. IUCIE COUNtY, FLORIDA ~
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~ 1 FURTHER CERTIFY that I wlil co~mply wtth ail other requlremenri of e lega) re:id~nt of tfilt State. ~
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rf FURTyER CERTIFY that i have no inteMion to return to my forrr~er domi~Jle, and ! intend to remain in FORT
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• ,~~1•~~.~1JCI~.~OUNTY, Fl.ORIDA, permanently..
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- :p z ~ - ~ _ _ _ . . (Name) i
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~ x' ~lb~rt9l Robi ac~n 1;dwarda ~
~ , r~~~~'' ,r; A ~ a - (Address) ' ~ . ~
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30th December ,~~q~., j
- Sworn to and :ubsuibed before me ifiis day of
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~ ROl3ER rOiTRAS ~
E CI.fRK CIR UIY C~URT Notary Public •
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- gy D.C. My Commission expi~es .
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(To b~ ~x~euhd in duplicah and orlpinal fil~ ~vkh,~'~j Cireuk~`' , and duptieaN wide Tauc Aavaora '
- 80~K lU./ FA~E2~~~
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