HomeMy WebLinkAbout2998 o?ec~aration ot Dornic~~e and Cltisenshlp 163¢58
TO YHE STATE AND COUNIY TAX ASSESSUR.
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citiunship in the State of Flo~ida that 1 am filin~ this day in soo~rdance and
~n conformity with Chapter Z22, Section 222,17, Flo~ida Statutes.
1 was Eormerl a 1 T~~SVILLB GBORGIA
y egal resident of
(City) (State)
411 EDGEWOOD CIRCLE DRIVB 1
and I resided at . However 1 have changsd my domic,ile i
(Street and Numbe~) i
~
to and am and have bcen a bona fide resident of the State of Florida sinte JULY 1St day of '
JULY 67 1150 BAYSHORB DRIVB '
- , 19 , and t reside at
(Straet and Number)
f~RT NERCE, SAINT LUCIE COUNTY, FLORIOA
and this statement is to be taken as my dectaration of citizenship, actual legal residence and domicile in the Stete of Florids.
pnsert here any pertinent facts, such as sale of property or busineu, or relinquishme~t of employment
at former domicile, removal of farr~ily to new domicile, purchsse of home, etc.)
HOMESTEAD PURPOSES -
aNp RECOR~EO
~II.E~~~E ,~OUNTY. FLA• .
gT. LU ~ZO v~g~F1E0
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I RIRTHER ~CERTlFY that ! will oomply with all other requirementa of a logal resident of this Stste. ~
I FURTHER CERTIFY that 1 have no intention to retum to my former domi~ile, and I intend to remain in FORT ~
- ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
. i
~
Name) _ ~
: f
• ~ GEORGE D. ADKINS '
- ~ _ ' • - ~ _ 1150 BAYSHORE DRIYE
~ ~ ^ "J ~
: _ (Add~ess)
. ca~ ~ , : 4 ' . ~
, ,
•.'SMCaus.~ti~~n~.3ubscribed before me this 12th day of .jANUARY 19 68 ~
v0' ~
' ~
~OG~ POITRAS ~
CIRCUIT COURT.~ Notary Public ~
f
~ •
gY O.C. My Commiuion expires
(To b~ ~x~cut~d in elup(icat~ and o~ipinal Rt~d with Ci~tk Circuif Cawrt, snd duplicat~ with Tax Asse~or
j
ao~K169 ~~2979
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