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- Decla~atlon ot ~omicll• and Citlzenship .~s~4~i ~
TO THE STATE AND COUNTY TAX ASSESSpR.
Sl, IUCIE COUNTY. FIURtDA:
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This is my declaration of Oomicile and Citize~ship in the State of Florida th~t 1 am filing this dey in aooordance and f
~n confo~miy with Chapter 222. Section ~22.17, Florida Statutes.
1 was forme~ly a legal res~dsnt of _ Jacksonville Florida
(City) (Sta»)
and I resided at 3220 C81'rev@i0 Mfe3t . HowevK I have changsd my domicjle
(Street and Numbe~)
ro arr,! am a~~d have beer~ a bona fide ~esident of the State of Florida since day of
_ November , 1966 , a~ ~ re:ide at 2725 So 25th street
(Street and Number)
FORT ~IERCE, SAINT LUCIE GOUNTY, FLORIDA
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and this statement is to be taken as my declaration of citizenship, sctual legal re:iderxe and domicile in the Staro of Horida.
(Inseff here any pertinent facts, such es sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicite, purchase of home, et~c.)
, Estab2ishing residence and applyin~ for homestead
t
FlLED ANO RECORDED ~
ST. LUCIE COUNTY. FLA.
RECORD VERIFtED
~ 163401 ,
'S8 JAN 10 pN! ~I:01
~:o~~~r ~-oi~~~.s~~=~ _
CLERK CIRCUIT COURT '
1 fURTHER CERTIFY that I wil( aompty with ali other requiremenis of a(epal resident of this State. -
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I FURTHER CERTIFY that I have no intention to retum to my former domiGle, and I intend to remain in FORT k
. PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. ~
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~ (Wame) i
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~ = • Ta~madge D. Baxter
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- ' • (Address)
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_ • ` lOth anaiirY , 68
~'~w~mttl'bnd subscribed before me this day of - ~ 19 .
ROG~ POtTRAS
CIRCUR COURT Nolary Public
gy ~ D.C. My Commission expires
t Ro b~ uaeul~d in doplieah and orioinal fi{~d wilb GKk qrarif Caret, and duplieata with Tax A~ssor.l
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~ ~~169 ~29~3 .