HomeMy WebLinkAbout0104 O~laration ot Domicil~ and Citiz~nship 1,~,~1 ,
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FLORIDA:
Thit is my d~clsntion of Domiale end Cit~bnship in tM State of Florida th~t I am filirq this day in aaoordano~ Ond
in oonformify with Chsptet 22?, Secfbn 222.17, Florkla St~tutes.
1 wss formerly a leyal rosident of West Pa~m Beach Fla.
(Cih) (Sta»)
and t tesidsd at 5958 ~ C,yprus COUrt ,~w~~ my ~n~N
(Street and Number)
ro snd am and have been a bona fids resident of the State of ~lorida st~ae l~t day of
,January , 19~1, and 1 reside a~ 2414 Royal Palm "Drive ,
(Strset and Number)
IrO~T N~CE. S~AINT LtIC1E C~lNTY, RORqA
and this statement is to be taken as my dedaration of citizanship, actual Isgal re:'~denoe and domkila in the Stste of Florid~.
pnsert hera any peMinent facts, such as sale of property or business, or relinquishment of amployment-
at forrt~er domicile, ~emoval of family to new domicik, purchase of horr~e, etc.)
establish residency for
. Homestead exemption purposes , .
ST~~L
C E C UNTY. F~A.
ft; Gp~~1ED -
1
~se oFC 3o a~. i i: o~
; ~
~ tZ0 POITRAS
~ - CLER CIRCUIT COURT
I RIRTHER CHtTIFY that I will oompiy with ell other roquirernent: of • lepal resident of tfib State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domiGle, and I iMend to ramain in FORT
PIERCE, SAINT LUCIE COUNTY, fLORIDA, permsnently.
J '
~~~Gerald B. erhard
~
_ (Acldress)
. " .
+ 30th December 68
Sworn to~a~nd_subsuibed before me this day of 19 .
1 : .
, ~ - R+Oa[~It ~01i~f
" CL~K C~'E . Notary PuW ic
. --1~
by - D.C. My Commission expires
' r~~ ~ ~.,,c~~~e~` ~
~T.. b..oo.ar~.a M d~plie.~. .ea aidnal fil.a wilt~ a.elc eMa~~ eow~,_.ea a~piia~. wi~h 7.x A~....e..~
~i~ ~ 104
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