HomeMy WebLinkAbout0105 ~
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~ecla~atfon ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 16353'7
51. WCIE COUNTY. FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aooordante and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
Westberry L. I. 8ew York
I was formerly a legal resident of
~~;~y~ (Staro)
and 1 resided at 9 Oriole ~8~ . However 1 have changed my domi~ile
_ (St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since 15th day of
__~gp~emher ,~q
6~, and 1 reside at 210 B~Yon Drive Port St. I,ucie
~ (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Flarida.
(Insert he~e any pe~tinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ;
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Establishing reaidence and applying for homeetead
FtLED ~ND RECORDED
ST. LUCIE COU~~TY. FLA.
R=.COR~"!~nlr:LD
1~353'~
'68 J~.'~ 16 P~~ 3: I I
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~ CL~RK CIRCU!T COURT ~
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I FURTHER CERTIFY that I will comply with al) other requirements of a leyal resident of thia State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. ~
.ti~::.i::,; ' ~ ;
_ ~ ` 'f~~~~ ~ , I
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; (Name) i
~•m-•~, J F Sha~
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" ~'I ~ 3 , . . . ; .
~ - . _ : ~ . ' (Address)
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~ ~ ~o ~ . Janaur 68 ~
~5vVoN~1 to and subscribed before me this 15th day of y . 19 • ~
~
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ROGER POITRAS ~
CIRCUIT COURT Notary Public ~
gy ~~~~''~'v`~ D.C. My Commission expires ~
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(To b~ ~x~cut~d in dupljuh and ori~inal fil~ v~nith CIKk Circuit Court, and dupliuh with Tau Ass~or.) ;
s001I~~ PACE
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