HomeMy WebLinkAbout2853 Oe~laration o~ ~omf~ilt and Citis~nship '
163354
TO THE STATE AND COUNTY TAX ASSESSOR, • ~
51. lUC1E COUNTY. FLORIOA:
This is my declaratio~ of Domicile and Citizenship in ths State of Florida that 1 am fili~q thit day in ~oo~~danoe and
in oonformiy with Chapter 222, Ssction 2Z2.17. Ftorida Statutes.
1 was fo~merly a(ega) resident of TS rrt H=u t~ I nd ~ ~ n~
(City) (Stet~)
and 1. resided et ~nRa Natth. ].b-th .JS~ts~t! . Howevar 1 have cha~ped my domic3le
(Sneet and Number)
to and am and hava been a bona fide residsr~t of the State of Florida sinoe 1~th day of
May , 19_~Z, and I roside at ~ 19Z1 C~~rus Av m~~• ~
(Street and Number)
FORT PIERCE, SAINT IUCiE COUNTY, RORIDA
and this statement is to be taken as my declaratwn of citizenship, actual leyal residence and domicile in the State of Florid~.
pnsert here any pertinent fads, :uch as sale of property or busineu, or relinquishment of employment .
at former domicile, ~emovel of famiiy to new domicile, pu~chase of iwme, etc.) ~
~
Sold property in Indiana and
xiah to appiy for hosestead exemption
FILED ANn RECOROED
ST•~~ OstO VvRlF EU • ~
163354
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~.RK CtRCU17 C~JURT.
1 RIRTHER CERTIFlf that I will comply with all othar requiraments of a te~al resident of this State.
! FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUIVTIf, FLORIDA, permanently.
^ •
t ` ~-tJ c/L_ f
(Name) l•!1n].S W. BOOYer ~
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dress)
• Sworn to and subsuibed before me this 9th day of Januar~ ,)9~8.
. ,
• . . . RQ¢ER ~;lOITRA3 - .
' ~ ~ l~ERK"CiRCtIR COURT Notary PuWic
= - -
- D.C: ~ My Cornmiu'wn expires
tA`'. ' :~j_` _
~ .
~:~~o ~ ix~arl~d in dupliealo anil ori~inal fil~d with Cl~eic praih Care~. and depliuta with Tax AsMaor.f
`~i69 ~~834