HomeMy WebLinkAbout2425 . ~ecla~ation ot Domlcile and Clti~~nship -1530`~'3
TO THE STATE AtvD COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORfOA: .
This is my declaration of Domicile and Gitizenship in the State of Fiorida that 1 am filiny this day in aco~rdanoe snd
in co~fam;ty with Chapter 222, Saction 222.17, Florida Statutes.
I was formerly a legal resident of N~wberrY Mich,~an
(City) (Stats)
end 1 resided at ^ R~At~ ent _ . Howev~r 1 have chan~sd my domicjle
(Street and Numbe~) '
to and am and have been a bona fide ~esident of the Stste of Florida since _ 15th day of
N~~ember ~ 19 66 ~ and I ~eside at 356 Midwa; Road, White City
(Stta~f and Number)
FORT PIERtE, SAINT lUG1E GOUNTY, fiORIDA
and this statement is ;a be taken as my declaration of citizenahlp, actuat 1e9a1 residencs and domicils in the State of Hotida.
(Insert here eny pertinent fada, such as sale of property or twsineas, or relir~qui~ment of employment
~ at former domicile, removal of family to new domiclle, purcha~ of hom~, etc.)
Establish Residency for homestead purposes
FILED AND RECORBED
ST. LUCIE COUNTY. fLA.
RECORO VERIFiED
`~'11 •
'6~ FEB 28 PM :02
1530'73
hOGER '01 i Rt,S
CLERK CfRCU1T COURT
1 FURTHER CERTIFY that 1 will oomply with all other roquiremsnn of a Ispal resident of ihis State.
I FURTHER CERTIFY that 1 have no intention to retum to my former domiGle, and I intend to ~emain in FORT
PIERCE, SA(NT LUCIE COUfVTIf, FLORIDA, permanently.
~ 1~~ li~~/~~S~K-
(Name)
, Robert Hetrick
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. '._~•~s:',;~_ (Address)
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~.~`wart~ 10: a~ ibed before me this x~ 28th day of February ~q 67
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. _ CL~;~UtT COURT No1ary Public
. By D.C. My Commiuion expires
(To b~ ~xaevbd in de~ifeab ~nd ori~inal Al~d whb CIKIc pra~N Coue~, and duplieN~ witi~ Tax AsMaor.)
- daoK164 ~242~
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