HomeMy WebLinkAbout2946 Decla~allon ot Domicile and Citis~nshlp 17~3~~g
TO THE STATE AND COUNTY TAX AS.SESSOR.
51. lUC1E COUNTY, FIORIDA:
This is my declarstio~ of Oomicile and Gitizenship in the State of Florida that I am filinq thls day in aooordanae a~d
in oomformity with Chspter 222, Settio~ 222.17, Florida Statutss.
1 was formsrly a legal roaident of h ew Yo rk Ci t y N Y
(City) (Stab)
and I rosidsd at 3336 167 th st seet F lushing my domidle
(Stroet a~d Number)
b and am and have been s bona fide ~esident of the State of Florida slnoe 23 rd day of
December ~ ~q 6?, a~ ~ rsside at P Q Box 612 _
(Street and Number)
FORT MERCE, SAiNT LUCIE COUNTY, RORIDA . .
and this statement is b be taken as my dedaratwn of citiunship, adual legal residenoe and domiale in the State of Horida.
qnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence for homestead
.
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I FURTHER ~ERTIFY that 1 wifl aomply with all otF~ requimrr~ri of a le~al ~esident of this State.
- t FURTHER CERTIFY that I have no intention to retum to my former domiti~e, and I inter~d to remain in FORT
PIERCf, $Al1~l~; LUC{E COUNTY, FLORIDA, permanently.
~ / ~ :
. ~F~~G%l~mcu- 1~.~ ~ 1
_ " ; = ~ Lavinia ~Na~~ R. Warner ;
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Swom !o and subscribed before me this 26th day December , 19~.8._.
ROGER rOiTRAS
CIRCUR COURT Notary Public
By a-'~''~'C ~.C. My ~ommiuion expires
(To b~ ~x~cvNd in duplksN and o~ Al~d whb Cli~lc Cie~a~it Co~l, and dupliat~ wilb Tax A~aor.)
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