HomeMy WebLinkAbout0178 Decla~atlon ot Domicile and Cltizenship ~.63589 ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance ar?d ~
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~n co~formity with Chapter 222, Section 222.17, Flo~ida Statutes.
oaeri~il ~ ' New Jsrsey
I was formerly a legal resident of
~~;ty~ (State)
and 1 resided at -___90 BTOOk81de ~Ve• A~1t 'S B____ ~M,ever 1 have changed my domiG~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _?~th_ day of
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October 19 b? , and I reside at774 S811d~a Drive Port St. Zucie ~ }
(Street and Number) ;
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or bus~ness, or relinquishment of employment
at former domicile, removal of family to new domicite, purchase of home, etc.) ;
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Est~blishing residence and applying for homestead
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FILED AN~ RECORDEO~
ST. LUCI ~ ~ RIFIE~`A.
RF_CO
~.s3ss~
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~ ~6~ JAC~ t a~I ?0 : 01
~ ,,~~Ras
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CLERK ClRCU1T COUR7
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
•~'t~t;
;~F•~~F~THF~Qr~f'kj2TIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
C, .
PIE[t~~Al~'-1.~1CfE :Cl~S,R±1TY, FLORIDA, permanently.
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' ~ • ! (Name)
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• -~?~`°':~~'J~ , James Tsdward endt
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> (Address)
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Swom to and suburibed before me this 18th day of J~u~3~ . 19 fi8
ROGER POITRAS
~ C K CIRCUIT CO T Notary Public
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~ gy ~ D.C. My Commission expires
(To b~ exscut~d in dupliut~ and oriyinal filed witl~ Cl~rk Grwit Cour1, and dupliw» with Tsx Ass~s~or.)
~ aaoK 170 w?c~ ~7~8
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