HomeMy WebLinkAbout1623 154542
O~cluatlon ot Domicfl• and Citise~ship -
Tn THE STATE AND GOUNTY TAX ASSES.SOR,
S~. LUCIE COUNTY, FIORIDA: .
~ This is my declaration of Domicile and Gitiunship in th~ Staro of Horid~ that 1 am filinq thi~ day i~ saoordano~ and
in oonformity with Chapter 222, S~ction ~22.17. Plorida Statutes.
- Pheniaviile~ ~
I was forme~ly a Is~al rosident of Valley Porge Gen.Hosp. Pa.
(City) tSt~t~)
ar~d ~ ros~dsd a~ % Valie y Porge Gen. Hosp. my ~„~1.
(Sheet and Numb~~)
to and am and have been a bona fide rosident of the Stats of Florida sinoe lat ~y ~
October , 1966 ~ a~ at Rt. 4 Box 155H ~
(Street and Number) _
t~ORT SAINT LUCIE COUNTY. 1'IORIDA
and this statement is to be taken as my declaration of citi~nship, actuai le~al residenos and domidle in fhs Stat~ af Horida.
pnss~t he~e eny pertinent fads, such as sale of property or bu:iness, or relinquishment of emplcym~nt
at former domicile, removal of family to new domicils, purchau of home, etc.) -
Filing for homestead purposes
F1LE0 ANO ~UNTY~~u~
ET. W C1E C
RECORD VERIF~E~ 154542
'6i APR 4 AM -1 t' 2 I
,
~
I NO~~R i'017R~S
tLERK CIFtCUI? COURT
~ i FURTHER GHtTIFY that 1 will aomply with all oth~r nquinments of a le~al rosidsnt of this Shte.
I FURTHER CERTIFY that i have no intention to retum to my former domicjie, and 1 intend to remain in F4RT ~
PIERCE, SAINT UJCIE COUfVTY, FLORIDA, permanentiy.
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$~ron~~~1~b and substribed befOrs me this -
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RO~Ek -
COURT Notary Public
.
gy D.C. My Commission expires
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