HomeMy WebLinkAbout0069 ~eclara~ion ot Domici~• and C~tisenship" ~ 15~~
v' .4
TO i HE STATE AND COUNTY TAX ASSESSOR,
S1. lUC1E COUNTY, FLORIDA:
This is my declaration of Domicils and ~itizenship in the State of Florida that I am filin~ this day in scoordanoe and
in conformity with Chapter 22~, Ssction 222.17, Florida Statutes.
I wa: formerly a legel roaident of LOUis~i11Q Qhie
(~iry) (Sts») '
and i resided at 9~a ~Olu~buS RO~d . However 1 have chanqsd my donrtiCile
(Street and Number)
to and am and have been a bona fida resident of the State of Florida sinte 28th day of
~y , 19~Z-, and I reside at ~2~5 Wc,gt L~tr~ 1]=;... .
(Straet and Numbsr)
port Pierce, Plorids
FORT PI~tCE, SAINT LUCIE COUNTY, RORIDA .
and this statement is to be taken as. my declaration of citiunship, actual lepal residenae and domidle in the Stero of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquisFiment of employment
at former domicile, removat of family to new domicile, purchass of home, etc.)
Sstablish residency for hosestead purposes
F~~~p AND RECORDED _
ST. LUC1E COVNT` ~FLA. 9~~
, ~~:-t'C• •
'
! + ~~-130 AM I I : 06
. 6T r
".(1".[r' ! {~'•~f
..J
CLERK C~RCUIT COUR7 ~ -
1 FURTHER CERTIFY that I will oomply wNh all othsr.drsquireme~ts of a lepal rosident of this Stste.
1 FURTHER CERTIFY that I have no intentian to retum to my former domiGle, and 1 intend to remain in FORT ~
.
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~t li
l~ary A. Yit
~i
_ ? ~ ~,~,~a_
(Address) ~
. ,Gf, ~ .GCiLcc-, ij~L
,:~,:.r,~n to and subsuibed before me this 30th day of +~gL,~~ . 19-b~
. ~ , : aY-,
_ r~ .
~ . ClERKc.C~CIJR COURT Notary Public
: tl
~y - D.C. My Commission expires
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Ro b~ ~c~cvhd ie duplic~ats and orioina! Al~d whh Clwtc Ci~uif Co~~t, aed duplicat~ wila Tax A~aor.)
~ g~x168 ~ ~ 69 ~
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