HomeMy WebLinkAbout0216 D~cia~ation of OomNtil~ and Citis~nship ~~3'~~
TO THE STATE AND COUNTY TAX A?SSESSOR, ~
51. LtJCIE COUNTY, FIORIDA:
This is my dsduation of Ow+~icile and pti~enship in th~ Stat~ of Florida that I~m fllirq this day in aooordano~ and
in aonformlty with ChaptK ZZZ. Ssction 22Z.17, Florida Statut~.
~ was fiormK~y a ~.9a~ resid«,r of Bridgewater Main
(tiy) (Stat~)
and ~ ros~d.d at Bridgewater, Main
(Str~st and Number)
to and am and have been a bona fid~ rosident of the State of Florida sinoe OCtobtt 31 ~y ~
, t9 68, a~+d ~~~de at 110 Tunison Avenue ,
. _ (Street a~d Number)
Port St. Lucie
NORT ~t~, S~AINT ttlC~ COUN'fY, lLORpA
and this :tat~sment is to be taken as my dsda~ation of citizenship, actual legai re:idenos and domidle in tfie State of Horid~.
qnsert hero any perti~ent facts, such as sale of properry or b~niness, or rolinquishme~t of employment
at io~mer domidie, ronwvai of family ro new domicile, purchase of homs, etc.)
•Intent to file for homestead exemption
~1~~0 AND R~G~R
sr, fcCrE co~N ~~oY
' ~l.A.=:
.~~~~~~b
'68 OEC 31 AM 9. .
y~ ~~57
i ~~cE '
~ CLERK C RCUIr ~
U~T:
~
~
I RJRTHER CdtTIFY that 1 wiil oomply with ail ~ nquinm~nfs of a lepal residsnt af fhb Stat~.
1 FUffTHER CERTIFY that 1 have no intentwn to return to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT UJCIE COUNTY, FLORIOA, permane~tiy.
? ;
Albert C. Fa y
~ (Add~nss)
- ~ 31st ~ Deceeber
S~wotn ~o and wbstri b~for~ m~ this of 1968 .
. ~ + ~ j'•.
~OIi~R [Of~M~`'l~ ~ . y ~
CLi~K C~CIA~ j : o• Notary Pubfk
by . D.C. My Conwnissfon ~xpihs
. ~ ; f .
~ ' ;
J
R. r. «~.eM~'1.. ..'..w~ «i~M~l w.r ww~ a.~lc araiN c.wl, .~i ~li..~. wtlM T.~c w.......a
~ '~{~.,i-:.tq_r->r • ~
si •
~
~ `
.~~"~:~M~_ . .