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HomeMy WebLinkAbout0638Da C~aZ2"AtlQtl of Domicit~ end Citiz~nahip TO TIIE STATE AND COUNTY TAX A.rSE3SOR, nn ~~Rk 49 ~~r~63~ 3T. LUCIE COUNTY, FLOF.IDA: CT, ~ I!("IE i_~~N'; ~~ r~A. This is my declaration of Domicile and CitizenahiP ~ the State of Flort:ta that I am filu~ this day in accordance and in conformity with Chapter 222, Section 222.17, Florida Statutes. I was formerly legal resident of H~e1tOWn _ [city] Pennsylvania State 45 Eit s t ~a in Street However, I •havs changed my domicile and I resided at [Street cnd Number] 30th day of to and am and have been a bona fide resident of the State of Florida since IDctober ~ 19 ~~ :na I reslae ::t dcute 3, BoE 508 `~ . [Street and Number] Orange Avenue b'ORT PIERCE, SAINT LUCIE COUNTY, FLORIDA, and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. atlforFi-ceredomicile,eremovalfoftfamily to new domicpertpurchaselof homeretc•juisYiment of employment Living in house and wisnea to establish residency for ho~lestead exemption purposes. ;. `;'~ .. , .'~ . .., ": ;~ •:: . ;; .1~ 033© Fll~ AND RECfl BDOK IN 1962 NOV 13. AM 1 ` : 58 CLERK R~~~IEP ~' NSA F/ 0~1DA s I FURTHER CERTIFY that I will regater at my local address when the reYistration bcolrs reopen, and comply with all other requirements of a legal resident of this State. x.FURTHF~t C°LRTIF°Y that I have no intention to return to my forme: domicil^, and I intend t'o~retrain in FORT. p~c>~, y5A1NT LUCIE COUNTY, FLORIDA, permanently. . ., ~ ~9 (.. r ~ [Name] Fr . ~~ - ~ George ,' . "„ ,. . ~._.~- ~i ~. - : ; [Address] ,:, . • . .. `~ r~~•_'.~• •'~<"' " 13th Nov Amber . ls~.~2. Svvorh to and subscribed before me thiA ~y of ROGER POIT7tP_5 ~ Notar; Public CLERIC CiRCUiT COURT ' SY ~ D.C. MY Comm'ssion ex"pires- [To be azecntesl in depllcate and original filed with Oterk Circuit Ooart, ands uuplicste with Ta3r Ass~~]