HomeMy WebLinkAbout0240 D~a~aration oi Domiai~~ and ~ItizMShlp 1'~3'~4
TO THE STATE ANO COUNTY TAX ASSESSOR,
ST. LUGtE COUNTY, FLORIDA: -
Thi:1s my declsration of Oomicile and Citiunship in ths State of Norida that 1 am filirp fhis day in aooorda~w end
in conformity with Chapt~? 424, Sation 222.17. Haida Statut~s.
1 was formarly a leqal rosid~nt of PROVID'BNC$ RHOUB ISI.AND
tCiy) (Sta»)
~nd I rosidsd at 302 DOUGLA.S AVBNUB Fbw~wr I haw charp~d my domic3l~
(Street and Number) .
to and am and have been e bona fide ros'~dent of ehe StaM af Florida sinoe _-~8th _ day of
~
J~B , 19 6 8, a~d I roside at 127 LOBSTBR ROAD ~ pT . ST . LUCIE, FLOR IDA
. (Street end Numbsr)
1'ORT NERC~, f~AqrT ltlCiE COUNTY, RORiDA
and this statbmsnt is ro be taken as my dedaration of citiunship, sctual legal residenos and domidle in th~ State of Ho~ida.
pnsert hero any pertine~t facts, such as sale of propery or business, cx mlinquishment of employment
at tormer cbmicile, ro~rwval of family to new domicile, purchase of home, eTc.)
HOMEST~AD PURPOSBS
F~LEO ANO RE~ORDEp~
_ ST. LUCIE COUNTY; F~q, - ~
~ECORO VERIFIEp y.
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'6e oEC 3 i i:~ ~ ~~'~3s4
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ROGER POITRAg
CLERK CIRCUIT COURT;
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1 FURTHER CERTIFY thit 1 will oompiy with ail oth~t nquiterrwnt= af a le~al re=id~nt of thb Stat~.
1 FURTHER CERTiFY that I have no intention to retum to my former domiale, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, pem~anently. ~
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