HomeMy WebLinkAbout2807 1~3~05
Declaratio~ ot Oomtcile a~d Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FIORIDA: ;
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This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filiny this day in aoo~rdante and
in oonformiy with Chapter 222, Sectio~ 222.17, Florida Statutes.
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I was formerly a leqa~ res~dent of PittsburRh Pennsylvania
(City) (Stsro)
and I resided at 1 100 PrinC~town Road . However 1 have changed my domi~le
(Street and Number) 15205
to and am and have been a bona fide resident of the State of Florida since 18th day of
Sent , 19 68, and 1 reside at 106 Aldea
(Sheet and Number)
FORT *I~CE, SAINT LUCIE COUNTY, RORIDA -
and this atateme~t is to be taken as my daciaration of citize~ship, actual lagal residenae and domicile in the State of Horida. :
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(Insert here a~y pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchsse of home, etc.)
Establish Residency for homestead
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FILED AND RECOROED
ST. LUCIE COUNTY. FLA.
CQR~ ~'~ilFIED
1~31os
~sa o~c Zo a~ i~: 3 i
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~ ::OG~OITR~;S
~ CIERK CIRCUIT COURT
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I FURTHER GfRTIFlf that I will aomp{y with all other requirements of a Ispsl resident of this State.
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I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I infend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
(Name) Joseph M. Blank ~
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(Address)
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• •~iw.om tcc=~ttd subsuibed before me this 20 day of llecember , ~q 68 '
' ROGER ~ M~iRAS
~ CLERK CIRQIIR COURT Notary Public
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By . D.C. My Commission expires
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(To b~ uucuhd in dupllcat~ and ori~inal fil~d wilh Cl~rk prwit Couh, and duplicN~ wHh Tax Aa~.)
daoK ~.~'4 ~~t Z80~
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