HomeMy WebLinkAbout2895 Decla~atlo~ ot Domicile and Citizenship ~
15~.284
TO THE STATE AND ~OUNTY TAX ASSE~SOR,
51. LUCIE COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in acco~danoe and
in oo~formity with Chapter 222, Section 222.17, Flo~ida Statutes.
~
Baltimore 2~3, Md.
1 w~s formerly a legal resident of - -
(Ciry) ~ (State)
4703 Wilkins Ave.
and 1 ~esided at _ _ However 1 have changed my domiCile
(Street and Number)
ta and am and have been a bona fide resident of the State of Florida since 19t~ day of
November ~ ~q 66 and I res'ide at 135 B. A1dNa St.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTIf, RORIDA '
and this statement is to bs taken as my declaration of citizenship, actual legal residence and domicils in fhe State of Horids.
(Inse~t he~e any pertine~t fads, such as sale of property or busineu, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
FILIN~ FOR HOMESTBAD PURPOSBS
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l.~p ~ RE~~~~ - '
s~ LUCIE C V R1~1~0 i
- aECO 151~
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C~RK CtRCUtT ~ _ - :
F
t RJRTHER CERTIFY that 1 will -0c>mply with all other requirements of a leyal resident of tfiis State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUN?Y, FIORIDA, permanently.
~t;::1::'~tttr~ee~~. - ~ (Name) ~
`
„'~~"~~.y nJ~~/J~f ViiRl\Vl\ A• H~ri\~ . .
''r j.•VU; ~ • ~
J:
t "Y ~C~L
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: ~ t ~~+:,15 p• ~ , (Address) ~
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;~~r:,%- ~~f' t 29th December 66
-j-,'~~-+~j~~d ~bsuibed before me this day of , 19 .
. \ ~j ~1~h~I~ f ~ .
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~OdER PO~TRAS -
a ~ _jtl1T C _ _ Notary Public
\ "
By O.C. My Commission expires
(To b~ ~x~a~t~d i YPIItiN s111I Or1~MI RI~II 1M~1I1 CIl~ CjfCYI~ COYff~ and duptiu» with Tax As~ssor.)
ao K~~1~ PAGE 492
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