HomeMy WebLinkAbout2156
EO r .\tE 53
Declaration: o~ TI?tonq~~~.q.L<;,itizenship
~
TO THE STATE AND coUNTY TAX ASSESSOR.
:iT. LUCIE COUNTY. FLORIDA:
O.R:
80=~
ll,1/~~1
This is my declaration of Domicile and CitizenJlhip in the State of Florida that I am filing this day in accordance
and in conformity with Chapter 222, Section 2'22.17. Florida Statutes.
s.e.
ORA NJ EBUID
I was formerly a legal resident of---------
[City)
State
243 Brop.d st.
[Str~et and Nwnber]
to and am and have boon a bona fide resident of the State of
and I resided at
AUGUST
lo"ORT PIERCE, SAINT LUCIE COUNTY. FLORIDA,
. However, I have changed my domicile
1st
__ day of
Florida since
62 280? Ave. p~
19__ ~ and I reside at
[Street and N\.Imber)
ar.d this statement is to be taken as my declaration of citizensh ip, actual legal re5idence an:! domicile in the State of F!r-orida.
[Insert here any pertinent facts. su"h as s31~ of property or business, or relinquishment of employment
at former do:n:cile. removal of family to new domi cile p'Jrchase of home, etc.)
FILI~n FOR HOMESTEAD PURPOSES
. .... !
.. .~C\J ii ~ :
.. '\ \ ",.... . .. .
...~ .,~v:\.. ......?
~ I...~:J_... i\,~.........-.
,O' "I, lit .. ..../ .
G : '.:.r-~';~":'.I.," ;1.',' .:
.~~:~.:t...~.:~~~ X
~U .,..... <:.
... a,~ CO.,
'"
11,l.lS1
r ~ r.-, .. ') :;;::,,- -. C",rp
1 ,~.,_..;" J 1 d.u\.. "Jel,
:., Oftic\6\ Record' C;j!(
\. .', - ~., - I
" J" I '.. 1\
i\;" !:: J~
r JU':.
S~. ~IJC\
< ~ ,I.:: :~:. ~:,l,<~.~i ~ '" ~
C:JJ~\~ 'I i LUI IL,..~
I FURTHER CERTIFY that I will register at m~' local address when the registrati')n b:oks reopen, and comply
with .1.11 other re'luirements of a legal resident of this State.
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA,
I FUnTlIF:R CER.TIFY that I have no intention to return to my former domicile. and I intend to rC:llain in
~. ,'.-
......- ~" . .:.. .:;... .:.' /:
~ ('.\s;_:e.\,\v, \: .....". '.
:. ."i,~~/ ~< ~::'~"':::~,:~~-:'.
3y
p"m'n.ntly~_ ~~ /
,/ JOHN L. WALKER
-- ~----~--------- --~--- ~~_._--
[Addre5s]
jay at
APRIL
63
~___~. 19
;O;-otary Public
---------~----------------------~-----_. - ------ .--------
_ D.C.
~Iy Commission expires
duplli'ate and orlgln~l file:! with Clerk Circuit Court, nnd duplicate with Tax M'ie5Sor)
~~