HomeMy WebLinkAbout1214 Declaration ot Domicile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR, 164164
Sl. LUCIE COUNTY, FLORIDA:
This is my decla~ation of Domicile and Citizenship in the State of : lorida Ihat I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~esident of ~ Opp Alab8lsS
(City) (State)
Route #~2
and I resided at _ _ _ _ _ _ . However 1 have changed my domiGle
(Street and Number)
to and am and have been a bone fide resident of the State of Florida sinte . lsth _ day of
231I N. 44th Street
_ _ JU~C---------. 19
68, and I reside at - ~
(Street and Number)
FORT PIERCE, SAINT ~UCIE CO~TY, FLORIDA
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 Froperty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
HOMBSTEAD PURPOSES
FILED AND RECOROEDI
' ST. LUCIE COUNTY. FLA.~
' RFCORt~S~RfF~ED
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i '68 FEB ~ PM ~1: Sy
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~~G~R :'OtTRAS
~ CIERK CIRCUIT COURT
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% 1 FURTHER CERTIFY ihat I will comply with all other requirements of a legal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in rORT
= PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ C. .
w'~G'ojU,,,~ - (Name) W. E. Pettrs
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~i'~~~'~;'`t~~i~;~ 2311 N. .44th Street, Ft.Pierce, Fla.
J.• ~~.%,~J,~~i~'x~r.?' ' -
~ r~'+ • ~ (Address)
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_ " . . f-•I.' rl?.~~~ ;
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: y~ ' .~.:y~•.~;4 ~ 6th Febeuary 68
~ti • ~'•:.~jnpw~~and subscribed before me this day of _ , 19
.
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ROGER POITRAS
CLERK CIRCUIT COURT Notary Public
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° By D.C. My Commission expires
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(To be executed in duplicate and originsl ~iled with Clerlc Circuit Cour1, snd dupliute with Tsx Assessor.)
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