HomeMy WebLinkAbout1461 Declaratio~ ot Domicile and Citizenshlp
152466
TO THE STATE AND COUNTY TAX ASSESSOR,
Si . IUCIE COUNTY, FLORIDA: `
This is my declarotion of Oomicile and Citizenship in the State of Florida that I am fili~p this dsy in soo~danos and
~ ~n aonformity with Chapte~ 222, Section 222.17, Florida Statutes.
I was fo~merly a legal res~dent of Charleston W.Va
(Ciy) (State)
and 1 resided at _ Rt 1 BOx i 0 . However 1 have chanflsd my domic3le
(Street and Number) j
ro and am and have been a bona fide resident of the State of Flaida since 19th day of
_ July ~ ~q 65 ~ a~ ~ reslde at 1311 Easter Ave. ~
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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and this~statement is to be taken as my declaration of citizenship, actual leyal residence and domicile in the Stste of Horids.
(Insert here any pertinent facts, such as sale of property or busineu, or relinqui:hment of employment
at former domicile, removaf of family to new domicile, purchase of home, etc.)
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Applying for homestead F~~p AND REG4~ D'~. ~
sT. LUCIE COUNTY. I~LA. ` '
RECORD VERIFIEO
lsz~ss
~6T FE8 3 AM I0: e~~,~G~
RUGER ~OITRAS
~ CLERK CIRCUIT COURT
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~ I RIRTHER G'ERTIFY that I will oomply with all other requiremenn of a(e~al resident of thia State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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,~~.~........;CO - (Name)
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- : Charles I..Rogers
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(Address)
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~ "';'~~ic~_.T:.- 67 ,
~v~ocrt'.t~ oad subscribed before me this day of Fehruar~ , 19 .
•
ROG~ rOtTRAS i
CIRCUIT COURT Notary Public ~
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~y °'`''4~ D.C. My Commission expires
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Qo b~ ~x~cvhd in duplical~ and ori~inal fil~e! wHh G~rk Graiit Ca+rt, and duplicat~ wHh Tsx Aiwaor.) ;
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aaoK164 P,~~459
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