HomeMy WebLinkAbout1272 Declaration ot Domicile and Citizenshlp
1s42o8
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of ~omicile and Citizenship in the State of Florida that I am filing tRis da•/ in actordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of ~8]1t1--- Ke19 ~ue]~V _
(G;ty) (State)
and I resided at iiL1tII- 1-BDZ-'-f However 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since r2th-_ _ day of
~ i95~__, and I reside ar 4803 Juanita Avenue
Au - - -
-
(Street and Number)
FORT PIERCE, SAINT LU~~E COUNTY, 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 property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILED AND RECOROED~
ST. LUCIE COUNTY. FL~atablish Beaidenoy Yor hosestea8 e=amption
~FI~"i~0
.
'68 f EB S AM 10 : 3 2
1642(18
~~~~_~~.F ~'O17R:,S
i CLERK CIRCUtT COURT
~
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi4le, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
~ ~L~~~
(Name) Y~c'. Arb1e N. Alle11
4803 Juanita Avenue, Fort Pierce,
(Address) O=' 8
8th February 68
~v~rom~to.qnd subscribed before me this day of , 19 .
; `J: C~/,,`,,
- RbGEIt Pbcf~i.S~~
: CtERK CIRCdIY~QLRT Notary Public
- ~
: c~
By - . D.C. My Commission expires
~ /i~; r •O . ~ ~
(To ~bd exgt
~uted in dupliute snd originsl filed with Clerlc Grcuit Court, and duplicate with Tax Assessor.)
eooK~7O PACE~.z~
~ ~ : X - - ,
~ ~ ~ ~ s °t.~-
~'~x--~~
_