HomeMy WebLinkAbout2763 D~cla~ation of Domi~ils and Citis~nship 1'?'30'7'?'
TO THE STATE AND COUNTY TAX ASSESSOR,
Si . IUCIE CQUNTY, FLORIDA:
This is my declantion of Domicile amd CitiZenihip in the State of Florida that 1 am filin~ this day in aooordanos ~nd
in co~formity with Chapte~ 222, Saction 222.17, Floride Ststutes.
1 was formerly a leyal rosident of AomewOOd Ill.
(City) (Sta»)
and 1 r~ided at 2422 183rd Street , Howevsr I have chan~sd my domidle
(Street and Number)
ro and am and have been a bona fide resident of the StaM of Florida sinoe ~t day of
, 19 68 and 1 roside at 320 Hollp Avenue
° (Sheet and Numbsr)
FaNtr neecE, s~u~r ~uc~ couNr~r, ao~w
and this statement is to be take~ as my decla~ation of citizenship, actual legai residenoe and domidle in the State of Horida.
(Inse~t here any pertinent facts, such aa sale of property or business, or relinqui~?mer~t of employment
st former domicile, removal of family ro new domicile, purchsse of home, etc.)
Filing for homestead eaemption
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I FURTHER GfRTiFY that 1 wiil oomply with all other requirement~ of a le~sl residsnt of this State. !
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1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remsin in FORT ;
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PIERCE, SAINT WCIE COUNTY, FLORIDA, permanently. ;
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. - ~a~~ harles Baker
~ . , . - URcJdress)
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~ ~ ~ e° , 19 December 68
`.,,.Sworn to end subsuibed before me this day of 19 .
ROGER rOtTRAS
CLERK CIRCUIT COtIRT Notary Public
By ~.C. My Commiuion expires
(Te b~ ~oc~urhd ie ~ and o~i~inal Ahd wi1i~ CIMIc Cina~if Court, snd dupikab wiM~ Tax Awa~or.)
a~174 ~z~57
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