HomeMy WebLinkAbout1526 ~
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Declaratlon ot ~omicile and Citizensh~p ~~8~ ~
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TO TNE STATE AND COUNTY TAX ASSESSOR, ~
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Sl. lUC1E COUNTY. FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in i?cco•dante and ~
in con~o~mity with Chepter 222, Section 222.17, Florida Statutes. ~
I was forme~ly a legal res:der,t of __.~~FI~`_____.^_ _ W. VA.
(Ciy) (5tate)
and 1 resided at ?18 _ CO11 BgQ AV9. Fiov„ever 1 have changed my domiGile
(Street arxJ Number)
to and am and have been a bona fide ~esident of the State of Florida since _____lat , y
_ da of
_ _A~1"11_ i9 66 ~ and ! reside at ____?Ol S. 218t St.
(Sireet and Number)
FORT PIERCE, SAINT lUC1E COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in ihe State of Florida.
(I~sert here any pertinent fads, such as sale of property or business, or reli~quishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FIZING F'OR HOMESTEAD PIIRP038S
~ FIlEO At10 RECORDED
ST. LUC~E COUNTY. FLA.
R~GOnC V~RIFIED
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'~a Q~C 5 AM l!: 49
15U480
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CL~RK CIc~CUi7 COURT t
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1 FURTHER CERTIFY that I will comply with all other requirements of a(egal resident of this State. i
1 FUR7HER CERTlfY that 1 have no inteniion to return to my former domicjle, and I intend ta remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentty. `
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(Name) ~
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~ ::';~~ty~~r~~~ RIITH T. 1PAGOAER ;
.-~,RN~.C~ Jyj''r ;
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~3 ~ ,5uvotn o and subscribed before me this 5th day of Deceannber 19 Fi6
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' C~ERK RC IT OURT f~totary Public
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8Y U.C. My Commission expirzs
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(To be sxecuted in duplicats sed o?iginal filed with Clerk Circuit Courf, snd duplicats with Tax Asses:or.)
600K 1~O PACE e~2~
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