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Declar~tlo~ ot Domicile and Citisenship •1~$98c~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl, IUCIE COUNTY, FLORIDA:
This is my declarotion of Domicile and Citizenship in the State of Florida that 1 am filing this day in aaordance and
in confo~mity with Chapter 222, Section 222.17, Florida Statutes. .
i
1 was forme~ly a legal resident of N~th Ari~ngton New Tersev _ ;
(Ciy) (State) ;
~
and I resided at __~__Hedd@17 TerraCe However I have changed my domic.ile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida s~nce ._____-_15-~- day of
March , ~q 66 , and I reside at Routt 2~ BOx 3~~ 321
(St~eet 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 Horida.
(Insert here any pertinent fads, such as sale of propery or busineu, or retinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establish Residencq for Homestead exemption
FIL.EO ANO RECQi~~ED .
S7•AECpRD VERI~IED~
14898~
'66 OCT 6 PN 2 :36
~ y"•
~ ROGER PO~T
, CI.ERK CIRCUIT COUR7
I FURTHER CERTIFY that I will comply with all other requirements of a(egal ~esident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domic~te, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
~
(Name) Douglas Robertson
x e]t ~!f
~ Elizabeth Robertson
. ~
r ,
SwoF~_ia .i?~i~ sybac~ibed before me this 6 t~ day of OC t O be t , ~ q 66
~~,ptss,r/ir;,,~
c~..; Q
: ~ . ' ?y
'~~`:~i~ ti~ .
.~~~•~Y•'~
~ ~Ct~RIC CIRCyI~ ~011R1 ~ Notary Pubiic
gy.~ ~ D.C. My Commission expi~es
_ ~ ~ •r -
.
''(?p~ ix~wNd in duplicat~ and original fit~d wkh Clerk Grcuit Court, snd duplicat~ with Tax Ass~.)
. ao~ 156 P~ 245
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