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HomeMy WebLinkAbout1276 ~ ~ I~ecia~t~tinn 4T DomiciiS and Citize~ship ;~S(~~i3~20 , 1 TO THE STATE AND COUNTY TAX ASSESSOR, Si. tUC1E COUMTY, FlORiDA- f This is my declarotion of Oomicile a~d ~itizenship in tha State of Florida that ! am filing th;s day in aooorclance and in conformity w~th Chapte~ 222. Section 222.17, Flo~ida Statutes. 1 was formerly a legal resident of Un1vCrSltq Height3_ OhiO tCiry) (State) and I resicied at ~ 2645 Y1t Utlivetsity Blvd. ~,,,~ever 1 have changed my domicila (St~eet and Nurt~ber) to and am and have been a bona fide ~esident of the Stete of Florida sic~ce 19th day of - August , 19 66 , and 1 reside ar 414 Oleander Ave., River Park, (Street and Number) FORT PIERCE, SAIi~IT LUCIE COUNTY, FLORIDA and this statement is to be taken as my declaration of citize~ship, actuat iegai ~esidence and domicile in the State of Florida. (Insert here a~y pertinent fatts, such as sale ot property or business, or relinquishment of employment ~ at former domicite, ~emovai of famity to new domicile, F+u?chase of home, etc.) HOMTsSTEAD PURPOSBS - FILED AND RECORDE~ ST. LUCIE COUNTY. FLA. RECOP.D V~R~FtED - .ts~~o _ ~6 hOV 29 pt~ 2: 36 ~-0:~~.-~ ~-o~~?~~s CLERK CIRCUIT COURT 1 FURTHER CERTIFY that I wi!! comply with al! other requiremenis of a legal resident of this State. , 1 FURTHER CERTIFY that 1 have no intention to retu~n to my former domiGte, and t intend to remain in FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~ : ~ (Name) R e ' W. Klingman ' 424 Oleander Ave. (Address) Sworn to and subscri~ed before me this 29th day of NOVembCi ~9 66 : ~,;~;«::Ne;~~ ' " - \i`'. 1t ' R4f - - L. l ~i . ROGER POITR/l5 J ~ a~ ~ ~ '•:p ; . CLERK CIRG COURT ; :c~ . Notary Public ` BY ' ` - ~ ~ , " ~ t ~ : " My Commissian expires "-r'. ~~tc) `G;, - t~} - . ti :ti,•-''~i, v' r Ro b~ ~xecuted in duplicah and. ''yl f~.Virith ~c~t Court, a.~u plieah with Tax Assfs~or.) j~f::l1,,:S:II~ QOO~~N,~LUU PACE /p - - - - . ~~z ~ ~ _ ` ~ ~ ~ Y~: - 'u _