HomeMy WebLinkAbout2958 ~ i
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~eciara~ion ot Doml~ile ~nd Citiaen~hip . ;
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~ TO THE STATE AND CC)UNTY TAX ASSESSOR, '
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~ SY. LUCIE COUNTY, FLORIDA:
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This is my declaration of Oomicile and Citizenship in the State of florida that 1 arn filing this d~y in accord~nce and ~
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in conformity with Chapter 224, Section 222.17, Florida Statutes. ~
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1 was formerly a tega! resident of ~
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~ and 1 resid~d at Main StreCt ' , Hawever 1 have changecl my domiCila ~
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' . to and am and have been a bona fide residenf of the 5tate of Florida since 19 rley of i
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~~i~ ' Novembex 64 ~55 Granada~ Street, Beach
, 19 , and 1 reside at ;
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I'ORT PIERCE, SAINY ~UCIE COUNTY, FLORIDA ~ • i
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end this atatement is to be talcen as my declarotion of citizenship, attuel legel residenta and domiclle In the State of Fiorida. ~
(Inse~t here any pertinent facts, such as sale of propeciy e~ business, or reiinquishment of employment ~
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v at former domicile, removal of family to new domicile, purchase of home, etc:) ~
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,,~~t~~tin,~~~~~
• Bstablishing re~idence • a~~~.'~,.; .
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~ CORQED ~ l~. :..~X,~,; _ ~4z. ~
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~ ~ 1965 JAN -4 Q~ ~ y,, ~ : -
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` ROGER POITRAS. CIf.RK . -
` . ~ ST. LUCIE COUNTY, flOR10A
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1,FURTH~R CERTIFY tfiat I will comply with alf ofher req~iroments of e leyai rosident of tfiis State.
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~ •t','Fl~Tk1ERs,CERTiFY thet I have no intentian to ~eturn to my former domi~ile, and I intend to rem~in in FQRT !
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e~,:.~~t- 'l-i'••. i? .
~ It~T'~6~CIE'6QUNTY, FLORIDA, permanently. i
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~ ~r ~ uj¢ " ~ • • ' . (Name)
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t ~~~•,~('1~K~ ~ ~ , ~dwaxd F. Covene~r
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~ ' Sworn to and subscribcd before me thia 4 dey of Janua~y • ~q 6~,
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> ~ R0~8ER PQI RA3
` ~ s . ItK CIR IT COUiC ~ Notary Pubiic
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~ gy D,C. My Commis:ion expiras ~
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(To b~ sxfcutn! in duplicab and oriQlnsl ~ilyd with CIKIc C~ra+it C~rf, ar+d duplksta witb fax Ast~aora
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