HomeMy WebLinkAbout1584~e~lar~tian of Donnicile nr.d ~iti~It~hip -
70 THE STATE AND COUNTY TAX ASSF~SOR, t~O~K `
51 f~~~.t2~U
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3T. LUCIE COUNTY, FLORIDA: S7, ~'!i ~~'-~"~!NT~, ALA.
This is my declaration o! Domicile and Citizenship in the State of Florida that I am filing this day in accordance
and in conformity with Chapter 222, Section 222.1?, Fiorida Statutes.
I was formerly a legal resident of ~Ea9t ChiCa~O ~ Ind~gB
(City] State
and I resided at X154 DBart;OJCn __ However, I have changed my domicile
(Street and Number] -
to and am and have been a bona Tide resident of the State of Florida since 30~i
October
day of
_~ Is62~ a.~a I reside ac _ 304 Riolnsr Drive
' [Street and N ber] __
- River Park, ~ort -ierce
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA,
and this statement is to be !aken as my declaration of citizenship, actual legal i'~sidence an.i domicile in the State of Florida.
[Insert here any pertinent facts, suih as sal^ of property or business, or relinquishment of employment
at fornier domicile, removal of family to new domicile purc}~ase of home,~etc•)
Establish Residency for homestead exemption.
Liking in uouse now.
~~~~~0
ICED aND ~E~D~D30~K
F c~,-.._
Its. ~ PM 2, p5
1952 ptC RpS, ~~~Rx
Rfl~~R P~OUN~'1 E
Sj . ~>J~If. ~
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a'r • , ~ L~
I FURTHER CI~i.TTFY that I will register at my local address when the registration books reopen, and comply
with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
FORT PERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
'; ., •'~.~~~; '~.;` ~ / ~• =~ Fay tte 4~I. Clog]
- -~ ' ~ (Address] -
Sworn ~o~~rtdi;ub~cribed before me this iay of D908ffiber lg 62
P,OGER POITRAS ~ __
CLERK CIRCUIT COvRT Notary Public
3y D.C. P.Iy Commission expires •
[To be esecuttd Ln duplicate and orlginaI filed with Clerk Circuit t:ourt, and dupllcxte with Tax Assessor]