HomeMy WebLinkAbout1610 D~cla~ation ot Oomlcile and CltisMShlp ~~2~65
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FtORiDA:
Thi: is my decluation of Oomicile and Citi~hip in ths State of Flaida that 1 am filin~ this day in aooorda~a qnd
in conformity with Chapte? 222, Section 222.17, Florida Statul~s.
Blne~ield 'Neat 4lrginia
1 was formerly a lagal rosidN?t of
(~ity) tSta»)
?04 - Rt. 3
and 1 resid~d af How~wr I have tharpsd my domWl~
(Strset and Number)
ro a~d am a~d have been a bona fida rosident of the State of Florida sinoe OCt. 16 ~y ~
~ 19 6S a~ ~ 338 8otlem Drive
(Stre~f and Numbsr)
~ORT SAINT LtlCIE COUNTY, ROR~A ,
and this stat~me~t is to be taksn as my dedaration of atizenship, actual Is~al res'rdenos and domicile in the State of Horida.
(Insert here any pertinent fatts, such as sale of property or busine~, or rolinquishment of employmsnt
at fiormer domidle, removal of family to new domicile, purchase of twme, etc.)
Parcheae home and intending to file for ho~eetead ezemption
.
rn
a~
~ a ~ ~n
Q r
7~Cp G nA0
. n fV r_~~ ft1 Z
~ ~ ~ ~w O~
GO "~nC~
n ~ ~
D ~
I .~N • af~
I ' ~ ~ ~
1 FURTHER GERTIFY that I wlil aomply with all othsr roquirem~nts of a le~ai ~idsnt of this State.
t
I FURTHER CERTIFY that I have no intention ro return to my former domidle, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
,
~
~ Jemee H. walYer
. (Nanne)
. ~
, ~ ~t - . - !
- - . - ~ ~Address)
~
-
' ~ 25th Aove~ber 68
;~•~S~n'lo`~nd substribed befor~ rr~ this day of , 19 .
. ~
ROOER rOfiRA:
CISRK CtCWT tO11RT Notsry Pubik
by D.C. My Con+mifsion ~xpir~
~T. ti..~.aiN~ r d~as.r..~ «i~r ~a.r wNb u«Ic cMaiM c.w+, aw~ ~iieM. w11M T.~ A.......J
„ ~~74 ~~1b~1~ ~