HomeMy WebLinkAbout2610 ~ Decla~atio~ of Oomtctle and Citize~ship 1532Q5
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the Stats of Fio~ida tfiat 1 am filin~ this day i~ atcordance and
-i~ ~or~formity with Chapter 224, Section 222.17, Florida Statutes.
I was formerly a tegal resident of _ Colut~bts , ~ Q Q~ a
(Ciy) (Staro)
and 1 resided at ~ . Howevar I have chanfled my domic3le ~
,
(Street and Number) {
ro and am and have been a bona fide ~e:ident of the State of fiorids sinoe day of ~
f
53
October , t9~, and I reside at 3419 Byron fl#reet
- (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, ROit10A
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and this statement is to be taken as my declaration of citizenship, attual Isgal re:idence and domicile in the State of Horida. '
(Insert here any pertinent farta, such as sale of property or business, or relinquishment of employm~nt !
~
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
Applying for homestead
,
F~lEO ANO RECORDEO
ST. LUCIE COUNTY. FLq,
RECORAS
E~ED
~ ~ 5
61 ~ 3 p~ Z: O t
~ =:o~~~ ~u:~~:.s
CLERK CIRCUIT COURT
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I RIRTHER ~ERTIFY thst I will comply with all other':raquirements of a leyal resldent of this State.
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I FURTHER GEitTIFY ttyt I have no intention to return to my former domicile, and I intend to remain in FORT
PIERCE, Salhl~`~~~1~~~NTY, FLORIDA, permanentiy. _
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, ~ ~ - . ~ / I
- ~ ' _ ' "a{
- a ~ (Nsrne) - - +
~;t • .i:'°' _ ~ . t• ~ ~ James Chambiey Jr ~ 9
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f •G0 ' (Addres5)
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Sworn to and subscribed before me this 3rd day of ~r~b ~~q 67 .
ROGER PORRAS -
CIRCUIT URT Notary Public
C~[~. ~
gy D.C. My Commission expires
(To b~ ~c~cubd ia d~pliuh and ori~insl Bl~d whh Cl~rlc Grah Courf, and dupliu» wHh Tax A~ssor.)
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