HomeMy WebLinkAbout0580 Declarallon ot Domicile a~d CltizeRShip
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FlOR1~A: -
This is my declaration of Domicile a~d Citizenship in the Stats of Fto~ida that t em filing this day in aooordance and
~n conformiy with Chapter 222, Section 222.17, Florida Statutes.
I was forme~ly a legal resident of Canton. Ohio
(City) (Stste)
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and 1 resided at _124? Pasedena Blvd ~,~,~ever I havechanged my domicjle
(Street and Numbe~)
to and am and have been a bona fide re:ident of the State of florida since ~St day of
__!~~ril ,~q
6? , and t reside ar 137 Liberty W~y Belle Air ~~t.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residente and domicile in the State of Horids.
(tnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence and applying for homestead ~
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FILED AND RECOROE~
ST. LUCIE COUNTY, FLA.
RE.COF.~ V~RlFI~O
163'759
~s8 ~~ri 23 a~ ~o : so
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CLERK CIRCUIT COURT
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' 1 RIRTHER CERTIFY that I will oompty with all other requirements of a leyal resident of .this State.
~~,hUI~TH~R CsERTIFY that I have no intention to return to my former domiwle, and I intend to remain in FORT
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PIERCE~;.~SAI~fT..«fG?E.'~.C~jNN, F10RIDA, permanently.
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~ . ~ ~ Carl M. Saylor f
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Sworn to and suburibed before me this 23rd day of January 196$
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ROGER POtTRAS
CLERK GIRCUIT COURT Notary Public
g~ °'~'r~~ ~ D.C. My Commission expires ,
(To b~ ~x~cut~d in dupliut~ and oripinal fil~d wkh Cl~rk Cirarit Co~rvt, and dupliu» with Tax Ass~ssor.) ,
a~K170 P~~ 578
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