HomeMy WebLinkAbout0798 Declaration ot Domicile and Citisenship
152041
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. lUC1E COUNTY, FIORIDA:
This is my declaralion of Domicite and Citi=enship in the State of Florida thst I am filinp this day in ata~rdanos and
in oonformity with Chapter 222, Snctian 222,17, Florida Statutes.
1 was formerly s legal resider~t of S~~
(City) (Stat~)
and 1 resided at 102 NiiT 156th St. - , However 1 have charpsd my domi~ile
(Street and Number)
to and am and hsve been a bona fide resident of the Stats of Florida since l~__ day of
J~' - . 19~ , and 1 reside at 763
(Street and Number)
PORT PIERCE, SAINT lUC1E COUNTY. RORIDA , ~
i
and this statement is to be taken as my declaration of citizenship, ectual legal residence anti domidis in the StsM of Horida.
(Insert here any pertinent fads, such as sale ot properfy or busineu, or relinquishment of employment '
at former domicite, removal af family to new domicile, purchase of home, etc.)
FII.ING FQR HOMFSTR~D PURP06ES
FIIE~ AND RECOAOEO
$7'. LUCIE C~UN'rY, trf.A.
RECORD VERIFIED,
152041
~ '6~ JAN 2o PN r: r 2
.
_ , ROC~ER ~oiTRas ~
- CIERK CIRCUIT COURT
e
,
~ M
I RIRTHER C'HtTiFY that 1 witl compty wNh all other requirements of a le~al resident of titis State.
; • ~
~ I FURTHER CERTIFY that I have no intention to return to my former domivle, and I intend to remain in FORT }
VIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
i .
` o cY ~
(Name)
.
- .,sti„~ ~ ~ ?t,.. F. JEAN AODGERS
.
,
, ~ -
•
J ' ; , ` . (Address)
. 1 ``i. ~ .
_ ~1.~ . /
~ ~ ~ ' danuaiq 6? ~
~ v Sw,orn~td•~ wbscribed before me this 20 day of ,~q
f • .l` .
. t ;
'
' _ , ; -1
~ . . a ; .
.
~ , , U URT Notary Public
BY D.C. My Commiu'wn expi~es -
lTo b~ ~aeut~d duplicab and ori~nd Al~d whh Cl~ek Gra~it Cour1, and duplicab with Tax Aa~s~or.) !
~
aooK164 ~ .?95 !
r .a~;~~ ~ ~ _ _
, ~ , .
1y
' ~ -