HomeMy WebLinkAbout0473 ~ Declaration ot Dor„icile and Citizenship ~
143248
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declarotion of Domicile and Citizenship in the State of Florida that 1 am filing this day in acoordance and
in conformity with Chapter 222, Section 22~.17, Florida Statutes.
W•
I was formerly a legal resident of ~eII~_,. isCOdSi~ _
(Ciry) (Stab)
Rt 5
and 1 resided at _ - - - However 1 have changed my domiti~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ____-28tb _ day of
_ Jul 65 Rt ~1 Beau Rii~age Stuart,
Y 19-___, and 1 reside at
(Street and Number)
FORT 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.
(Insert here any perti~ent facts, such as sale of propery or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
l~pplying for homestead
. RECOROE~
. - ~ FI~ED AND ~g00K
v IN.
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~ 1~...''~•:...:.:••~.`.~ R~ST LU~IE COVN
C C 1't C' F~„ORIDa
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I FURTHER CERTIFY that I will comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT lUCIE COUNTY, FLORIDA, permanently.
_ ' ~ ` L>,•,'' / /'~~~G(/u- t;///
. ~Y~F. j
y,~ ; - (Name)
-,;r+b~•• :ts~j ; _ ~S1r1 .StBr~C
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'.,:;f1C,.z G t~r~. 2nd March
~ '1•~j~KWbrn to and subscribed before me this day of , 19 66 .
ROGER POITRAS
K CIRCUR COURT Notary Public
By ~~'~''4'~ D.C. My Commissio~ expires
(To b~ ~x~cuted in dvplicats and ori~inal fil~d with d~rlc Circun Court, and duplicat~ with Tax Ast~or.)
~
BOOK
; ° R 139 . 470.
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