HomeMy WebLinkAbout0559 _y~y1.i
D~vla~ation- ot Domicil~ ant~ Citisen~ip
:
TO THE STATE ANO ~OUNTY T.U( ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my detlarotion of Oomicile and Citizenship i~ ths State of Florida that 1 am filin~ this day in aooordsno~ and
in oonfo~mity with Chspte? 222, Section 222.17, Florida Statutes.
ST . JAMES, IANG ISI.AND N. Y. ;
1 was formerly a legal ~esident of j
(C~y) tSta»)
S~aith Lane '
and 1 residad at Fbwever I have chan~sd my domicile
(Str~tt and NumbK)
14~h
ro and am and have been a bona fide r~ident of the State of Florida since _ - ~eY ~
Novevber 67 3705 S. Yndian River Dr.
, 19 , and 1 reside at - -
(Street and Number)
fORT PINtCE, SAINT LUCIE COUNTY, RORIDA i
snd this statement is to be taken as my declaration of citizenship, actual legal residence and dorreidle in the Staro of Horid~.
(Insert here any pertinent fads, such as sale of property or busineu, or relinquishment of employment
, at former domicile, removal of family to new domicile, purchase of home, et~c.)
To establisb residency and '
Homestesd~exeaption purposes.
- ,
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I FURTHER CHtTiFY that 1 will aomply witfi al) other requirements of a leyal resident of thls Stste.
. i
1 FURTHER CERTIFY that I have ra intention to retum to my former domicjle, and I intend to remain in fORT ~
_ i
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
c
~ • '(Na M. Tayloz ~
;
~
(Address) ~
~ 21st . ~
9Ys* hovesber , 19~ ~
Swcun •to and subscribed before me this day of ~
J` - t
~ - :f ~Wi~? Mi~i - !
~ C~~~ ~g , Notary Public ~
~ t
gy D.C. My Commiss'wn expires =
~
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, i
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(To b~ uncvhd in dvplieah and ori~inal Al~d with Ct~lc ~ Cour~, and duplicat~ wilb Taoc AsMa~or.f
eooK 16g Pacf 554
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