HomeMy WebLinkAbout0458 C
D~aluaNon of Don~tail~ and Citls~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
ST. ltJC1E COUNTY, FlOR1~A:
This is my decla~ation of Domicils and Citiz~n~ip in th~ Sta» of Florida that 1 am filinq this day tn aooordana ~d
in aonformity with Ch~pter 222, S~clion 2~2.17, Fbrida Shtut~s.
i w., ~~ir , ip,i ~;~,t ~ Statten Ieland 8ew 7orY
(City) lStat~) -
snd 1 ~sid~d at 24 Lo~ust P18C! _ I~low~var 1 haw charp~d my domidl~
(StrNt and Nun+ber)
ro and am and haw be~n a bons fide rosW~nt of the State of Florida sinoe neteher 21 ~y ~
,~q~, a„~ i~~e ~ 360 Sandia Drive (P~rt 3t. Lnaie)
(Stre~t a~ Number)
I~ORT M~C~, SAINT WCIE COUNTY, lIOR~A
end this statement 1: to be taken as my dedaration of dtizanship, actual le~aal residenae and domidle in th~ State of Horida.
q~t here any pertineM facta, such a~ sale of property or businsss, or mlinquishrnent of employrrNnt
at formsr domicile, romoval of family to new domidk, purchase of home. Nr.)
Dsclaring reeidenQe in the State oi Flori.da ~
and inteat to file ior Homeatead eze~ption
FILE~ AND RECOROED
ST. ~UCIE COUNTY. FLA.
~ECORp V£RlFIED
i~ss~.~
'68 OCt 2 4 PM 3: 0 I
.~~.J
ROGER p01TR~a
CLERK CIRCUIT COURT
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i RJRTHER CHtTIFY that 1 will oomply with all ott~ requinm~ntt of a lepai r~ida~t of this St~te.
I FURTHER CERTIFY that I have no intention to retum to my former domidle, and 1 intend to re~r~ain in FORT
PIERCE, SAINT LUCIE COUMY, FLORIDA, permenently.
v'
. . '
~ (Name) g~a C theri e
. . `~'L- - l[ille~eack
- jr,r ,
` - ~ r. = (~ddfQfS)
•t . , r.::r.
' ~ ' 24 Ootober 68 "
~t~t arid wbsuibed before me this day of 19 .
G{1.~;•
' kOO~R ~OITRA~
GiRK _t~6Y~~= Notary Pubik
8y D.C. My Commission expiros
(Ti b~ ~arl~d M d~plicaN a~ ~ iiwd wMb CM~k q~r~if Gw~, awd d~plialr wi~ Tax A~or,l
~~74 P~ 4~
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