HomeMy WebLinkAbout0466 1~'~¢ 9/
D~claration ot Dornicii~ and Citis~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY. FIORiDA:
This is my decla~atio~ of ~omicile snd Citizenship In th~ State of Ftorida that 1 am fili~ thit day i~ aooordano~ and
i~ aonformity with ~hapter 222, S~ctlon 222.17, Florida Statut~.
I was formsriy s Ipal rosid~nt of Dixon Illinois
(Ciy) (Stat~)
end 1~tded at 316 So. Dement Avenue
(She~t and Nurnbe~)
ro and am and have been a bona fide rosident of t~e Staro of Florida sinoe Aug. 4 ~Y ~
,~9~fi.Z, and ~ rostde a~ Route 4, Beau Rivage~ Stuart . Fla.
(Street snd Number)
ro~ n~tc,~. sr~ tuc~ cou~mr. ao~row
and this statement is ro be taken as my dedaratio~ of dt~enship, actual Is~a{ residenoe and domicik in ths Sts1~ of Horida.
pnsert hem any pertinent facK, such as sale of property or busineu, or mlinqui~me~t of empioym~nt
at formar domicil~, romovai of family to new domicile, purchase vf horr~e, etc.)
Filing honestead exemptioa
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I FURTHER CHtTIFY that 1 wili aomply wltfi a!I oth~r nqui~ts of a lepal residsM of thts State.
I RJRTHER CERTIFY that I have no intention to retum to my former domicile, and I intend to remain in FORT
PIERCE,_$~4Jf!tT t,UGE COUNTY, FLORIDA, permanently.
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G,•-, • p viiiano
•~,;;~.f~ (Nsme) Louis .
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'•bwiorri to and wbsaibsd before me this 6th daY ~ JaAUary ~ 19 69
ROOER rO11R/1S
Q~tK CIRCUIT COtIRT Notary Publk
By O.C. My Gommistion txpires
a. b. .oo.~w.a i~ d~e«. a~a e~ fii.a ,~ri~l~ a.~iC ck~t c~w+, .~a au~. u,i~ T.x As..»o.a
g~OK1r/~ ~V~
- No. 13
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