HomeMy WebLinkAbout0188 Deciaration ot Domicile and Citisenship
TO TNE STATE AND COUNTY TAX ASSESSOR, -
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accorda~ce and
~n confo~mity with Chapte~ 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of ~a$h111$tOII D• ~'i• _ ,
(C;ty) (State) ;
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and 1 resided at ~
0____5_ R~~tenhouse Stree~ N. E. However 1 have changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since _.______~~}1 day of
-----Se~tembo~- 19-6-? , and I reside af ,~03 North 22nd Straet
(Street and Number)
FORT PIERCE, SAINT WCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal res~dence and domicile in ihe State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.)
~stablieh Residency F~~ED AND RECORDED
ST. LUCIE COUNTY. FLA.--
' Homestead e=emption ~E CORn V~RiF~ED
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J ~se ~nrr ~ e PN 12 : i y
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CLERK CIRCUIT COURT
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1 FURTHER CERTIFY that I will oomply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domiGle, and I intend to remain in FORT
?IERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
1 ~ C~
(Name)AlIDB B• I~eB@8~1e
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~ ~ ~O~r;~T~`%:, ~'S North 2nd Street .
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43 ~ . 4 ; (Address)
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~ , 4 .,'~y~or~i ~ and subscribed before me this a+~+ day of ~nnt~nrv , 19~8.
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' ~ ~O~ER POITRAS '
CLERK CIRCUIT COURT Notary Public ~
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gy D.C. My Commission expires #
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(To be execut~d in dupliwt~ and ori~insl ~iled with Clerlc Grcuit Cour~, and du iwt~ with Tsx As~essor.) i
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