HomeMy WebLinkAbout1303 , DeCla~ation ot Dorr~icile and Citisenship ~s2363 ~
TO THE STATE AN~ ~OUNTY TAX ASSESSOR,
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51. IUCtE ~OUNTY, FLORIOA: F
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This is my declaration of Oomicile and Citize~ship in ths State of Florida thst I am filin~ thi: day in aooo~d~nce and
~n conformity with Chapter 224, Section 222.17, Florida Statutes.
I was formerly a legal ~esia~ant of 01ie3,da NeM? Yor1~ -
(City) (~str)
a~c! I resided at _-113_~p[18.L stLeL . However I have than~sd my domic3le
(Str~et and Number)
;o and am and have been a bona fide ~esident of the State of Florida sinoe --28th- day of
__~uly , 19 67, and 1 reside at 1901 North 35th Strect~ S»n1,~id Gardep8
(Street and Numbsr)
FORT PIERCE, SAINT IUCIE COUNTY, RORIDA
and this statement is to be taken as my detlaration of citizenship, attual legsl residente and domitile in th~ State of Horida.
(Insert here any pe~tinent facis, such as sale of propxty or business, or relinquishment of emptoyment
at fo~mer domicile, removal of family to new domicile, purchase of home, etc.)
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f ILE~ AND RECORqED~ ~ • _
ST. LUCIE COUNTY. ~tA:` Establish Residencq for ho~estead
, RE CORD V~RtFIED
162363 exe~ption purposes.
'61 OEC c AN II: 12 ~
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itO~Er~. i'OITR:.S
! CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that 1 will aomply with all other requiremsnts of s le~al resident of fhis State. ~
I FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in fORT
PIERCE, SAINT LUCIE COUNTIf, FLORI~A, permanently.
- „ f ~O~-., .
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(Name) Walter D. Pierce
- (Address)
'`:Sv,iioFw~to:snd'sybscribed before me this 6tb day of ~Celtbtr ~~q 67.
. : ? i ;
~ • T _ Notary Public
„ : c~c ~cu~t~ouR
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gy D.C. My Commissi~n expires
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(To b~ uc~arhd in duplicai~ and ori~inal flbd wAh Cl~lc Cirsuif Court, and dupliuta wide Tax AtNSSOr
)
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