HomeMy WebLinkAbout2994 Declaration aY Domicile and CNtsenship 163455
TO THE STATE AND COUNTY TAX ASSESSOR.
Sl. LUCIE ~OUNTY, FlORIOA:
This is my declarotion of Oomicile and Citizenship in ths State of Florida that I am fili~q this day in aooordsnoe and
~n co~fo~mity with Chapte~ 222, Section 2?2.17, Florida Statutes. ;
LIV INGSTON N •.T • ;
I was forme~ly a legal resident of
(~ity) (State) ~
and 1 resided at 3? Hazel Ave. 1~ ~~/1eV~ ~ have chan9ed my domic3le
($traet and Number) ~
25th ;
to and am and have been a bona fide ~esident of the State of Florida since - day of
Noveober 6T 705 Sandia Dr.
, 19 and I reside at
(Strcet and Number) -
FORT PIERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be taken as my declaration of citizenship, ectual legal residence and domicile in tlw State of Horida.
. (Insert here any pertinent fads, suth as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~eVv domicile, purchass of home, etc.)
FILING FOR HOMESTBAD PURPOSES
FILE~ AND RECOROED
ST. R~ C ~D ~ ERIFIEULA~ ~63455
'68 JAN I 2~ t I: I 2 ~
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'I~ ;~~.,t;:_ ~OtTks15
CL~RK CIRCl117 COURT
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I FURTHER CERTIFY that 1 will oomply with all other ~equiremenfs of a leyal resident of this State. i
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t FURTHER CERTIFY that I have no intention to ~etum to my former domitile, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
O ' K~ .
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,~~.;~~s,~~~?i:^,,~ - ~ (Name
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• = RUSSBI.L F. NEWICK
JG. _ _ ~
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? ~ ' ~ t, . .#~.z (AdclresS) ±
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- - : i 's'; 't . - 68 ;
~'j? : i i ~ 12 Janua ry
~ - ~ ~ ~ Sino~n.~ti4`A¢-~subxribed before me this day of . 19 • ~
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l{1~~•'~~~;•:
• ~WER
CI T COURT Notsry Public
gy D.C. My Gommission expires
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(To b~ ~x in duplicat~ and ori~inal R{rd wkh Cl~+~lc Cira+it Coi+~t, and duplica~o witb Tax As~aor.) ~
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