HomeMy WebLinkAbout2907 Decla~ation ot Domicll~ and Citize~ship 1633~i
TO THE STATE AND ~OUNTY TAX ASSESSOR, !
;
Sl. lUC1E COUNTY, FIORIDA: '
~
I
This is my declaration of Oomicile and Citizenship in the Stats of Florida that 1 am filinq this day i~ aooordanoe and
in conformity with Chapter 222, Settion 222.17, Flo~ids Statutes.
I was formerly a lega) resident of ~C8$,0.- _ Tl,l i r~ ei ~
(City) (Sta»)
end I tesided at -___j~46 ~~At Y.~nn,Rt . Howev~ 1 have chsn~ed my domitfle
(Straet and Numbe~)
to and am and have been a bona fide res~~ent~. the State of Florida since 1Bt day of
_ ~s JLU1e , 196~-, and 1 reside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, aaaow
and this statement is to be taken as my declaration of citizenship, actval legal residence and domicile in the State of Hotida.
~
(Inse~t he~e any pertinent fatts, such as sale of property or busineu, or roli~quishment of employment
st fomner domicile, removal of family to new domicile, purchase of home, etc.)
Homeatead ezemption purpooes
C4R~E~ "
0 AN~ TY• F~~
F~~-E ~~E ~FtE~
I si. ~F
~~F~.o~91
1 ~ : 2
,6~ 1AN
i'0'~~ pUR~ ~
:~p ~~-,~CV~S C ~
C1-ERK C
1 RJRTHER ~ERTIFY that 1 will oomply with all other requi~ements of a le~al resident of this State. .
1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain +n FORT
PIERCE, SAINT LUCIE COUNTIf, FLORIDA, permanently.
~ ~ ~ ~Z
tNa )1[re. tonia G. Pieper
~
421 ~oconut Avenue
(Address)
&warrr`tD arii~,subsuibad before me this lOth day of da111i8Z'~'_ , 19~~.
` .
• ~ ~ - _
~ ~ ROGER ` POiTRAS =
ClERIC CIRCUR COUR Notary Public
.
gy - ' - O.C. My ~ommission expires
(To M~x~evt~d in duplical~ and ori~inai fii~d wilb CIKk Grwif Covrf, and duplicat~ wkh T~x As~or.)
i `GOK~~ PAPf~8~