HomeMy WebLinkAbout0056 Declaration o! Domiclle a~d Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, .14~t1 L~;~ _
51. IUCIE COt1NTY, FLORt~A:
This is my declaration of Domitile and Citi=enship in the State of Ftorida that I am filing this day in aco~rdance and
in conformiy with Chapter 222, Section 242.17, Florida Statutes.
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• 1 was formerly a legal ~esident of ____~BeBYer _ 4` _ w. Vg•
(Gty? (State)
and I ~esided at Rt_ _9 _ However 1 have changed my domitiule ~
(St~eet and Number) s
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to and am and have been a bona fide resident of the State of Florida sinte -.__.______?Oth _ day of
-__J"°e , t9__ 6 and ~ reside ai 2320 ATlantic Beach Blvd,
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal resider?ce and domicile in the State of Florida.
(Insert here any pertinent fads, such as sate of property or business_ or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.) }
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Applying for homestead
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I FURTHER CERTIFY that I will comply with all other requirements of a tegal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and 1 intend to remain in FORT
PfERCE, SAI(11T, LUCtE COUNTY, FLORIDA, permanently.
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' ~ - (Name)
I . - ~ ~ . ~ " ~ Homer Harvey ;
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Sworn to and subscribed before me this 22nd day of Feb. ~q_ 6b ,
,
ROGER POITRAS
K CiRCUtT OURT Notary Public
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B D.C. My Commission expires
(To b~ ~x~cut~d in duptiuh and ori~inal fil~d with Ct~rk GrcuH Court, and duplicat~ with Tax Ats~ssor.)
BOOK 1~9 53
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