HomeMy WebLinkAbout0937 ~ D~cisration ot Oomlcll~ a~d Cltis~nship :L''?'~950
TO THE STATE AND COUNTY TAX ASSESSOR.
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in ths State of Horide thst I~m filin~ this day in aooordanoe end
in aonformlty with Chapter 222. S~ctio~ 222.17, Florida Statutes.
gt~ Wayne Indiana
1 was formerly a le~al rosidtnt of
(City) (Stah)
snd I rosid~d at 928 benwood Ave . _ ~r~
(Sheet and Number)
ro and am and havs been a bona fide ros'ident of the Staro of Florida sinoe ~Qt • 1 - day of
, 19 68, a~d ~~ide at ~~2 ~ Boz 3675
(SNeet and Number)
l~ORT MERCE, S~AN~lT LUCIi COUNTY, llOR10A
and this staMment is to be taken as my dedaration of citizenship, actual legal residenoe and domiale in the State of Horida.
pnse~t here any pertinent facts, such as sale of proparty or business, or relinquishment of employment
st former domicile, ramoval af family b new domicile, purchase of home, ei~c.)
Pnrchaee o~ home and filing ior homeetead
ezemption
FILEO AND RECORO~D ~
. ST. LUCIE COUNTY. RLA. ~ ~
RECORD VERIFIED ~
1'71950
~ '68 NOY 7 PM I: 13
~ Ro a ~o~TRas
~ CLER CIRCUIT COURTf
I RJRTHER CHtTIFY tfiat I wili oomply wHh ali otf~sr roqui~em~nt~ of a lepal rosident of this StaM.
1 FURTHER CERTIFY that I have no intention to retum ro my former domiGle, and i intend to remain in FORT
PIERCE, SAINT WCIE COUWTIf, FLORIDA, permsnently. -
•v ~
J ~r,,1e~ Car . O s
eanne e . o s
(~?ddress) ~
sw«n ~o,a~d~.ab~,a~b.d before me thi: Tth ~y Bo~esber , 19 68. i
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~ E~C1NT C011RT Notary Publk
by D.C. My Commiuion ~xpirss
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R~ r. ~e+ir~~ iN ~ a~i «yi~al AM~ wiM~ G«k c.iiwiN C~w~t, .wi ~lieil. wi1M Ta~ A~.,1
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