HomeMy WebLinkAbout2162 Wclaratlon ot Domicil~ a~d Cit~:~~ship 1'72652
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. ltlClE COUNTY. FLORI~A:
This is my declaration of Domicile and Citizenship i~ tM Stats of Horida that 1 am filinp thii day in aooordano~ ~nd
in aonformity with Chapter 222, Sectio~ 222.17, Florida Statuta.
I was formerly a leqal resident of SeBm 2l ~ OhiO
(City) (Sts»)
204 ~ Forreat ~e Avenne
and 1 rosided at . Howtver 1 have charpsd my domidl~
(5treet and Number)
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b and am and have been a bona fids rosident of the State of Florida sinae Oetober 9 ~y ~
, i9 68 , and i roside af 3424 Carlyle Street
(Stree~t and Number)
ro~rr ~ecE, sn~ tur.~ couNn, ao~uow
and this statament is ro be taken as my declaration of citizenship, attual legal residenoe a~d domicile in the Staro of Florida.
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(Insert hers any pertinent facts, such as sale of property or bu:iness, or relinqui~me~t of employment
at former domicils, removal of family to new domicile, pur.fiase of home, etc.)
Filing for homeeteed azemption
: . .
~ILEO AND RE6QSOE0
s .~~CUEiE CQlii~*Y.~FLa.
E'f~~ ~ 1'~.~..~lF!E~J
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t~o~:.~ ~~rRas
~ CLERK CIRCUIT COURT
i RJRTHER G~RTIFY that I will aompiy with all oM~er roqui~b of a lepal ~Went of this Stah.
I RIRTHER CERTIFY thst I have no intention to return to my former domicjle, and 1 iMend to remain in FORT
PIERCE, SAINT LUCIE COUNTIf, FLORIDA, permanently.
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y'sw~orn ~o and wb:uibsd bs~• m. ~h~s 6th ~y ~ Decs~ber tq68 .
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