HomeMy WebLinkAbout0496 o~c~aratlon ot oom~c~~~ a~d CltisMShIP l~'351
~
TO THE STATE AND COUNTY TAX A~R,
Sl, 1t1C1E COUNTY, fIORIDA: ~
This is my declaration of Domicile a~d Citiunship in ths St~ts of Florida that 1 am filinq this day in aroord~no~ a~d
in aonformity with Ch~pter 24?. Settio~ 222.17, Florida Statuhs.
3 ~
1 wa: formsrly a Ipal msident of Cherleeton Wset Vs.
(City) t5tst~I
~
and ~~~d.d at ?51 So. Park Road i~~ ~
. (Street and Numbe~)
to and am and hsve b~en a bona Hde rosidsnt of the Stats of Horids sinoe S•~ t~mbAi" 18 dey ~
; 19~a, and 1 roside at 182 Neet Brima Piete Blvd
(Stre~t and Nurr~r)
i'~ORT MERCE, SAINT UlCIE COUNTY, ~LORIDA
and this statemsnt is to be taken as my deda~ation of citizenahip, actual legal residenos and domicile in the State of Flotid~.
qnsert here any pertinent facrs, such as sale of propery or bu:iness, or relinquishmant of employment
at former domidle, removal of family to new domicile, purchase of horr~e, etc.) -
~ Fjling for..hoaeBtead ezemption
RilEO I~tiND RE~QRD~p~
ST: LUCI~ ~OUI~i1`Y. FLA. ' '
R~COaO VERtFfEO
1'~351g
~ s~ t:oe
~ ~
' R R POITRAS ;
~ CLE CIRCUIT COURTI F
I i
V -
~ i
~ ~
~ I FURTHER CHtTiFY th~t 1 will oomply with ail other roqulrarwnt: of a lepai rosident of this State. ~ ;
F
I FURTHER CERTIFY that I have no intention to return to my former domitile, and i intend to remein in FORT
PIERCE. SAiPtf, ~,IJCtE COUNTY, FLORIDA, permanently.
~;-s t
~:tt~;~~, ; ~ •
: ; ?
- _ (Name C. ~estly Harrieon
- . .~s= .
. ~ .•j
. . ~
~ . ' =
- ..~:;l,~- (~4ddress)
.
'';si.l94
r
: ~ _
r n •
~ ~ 6th Jannary t~ 69 -
Swom ro and subsaibed before me this day of , .
RO~iER ~OfTRAS
CL~K C~CUIT COURT Notsry Public
gy t d! D.C. ~ My Commistion ~xpires
a. .ocs~w.a i~ aup~. .~a «i~al fil.a ,~,i~ u..k cka~M co~~+. .~a d~k.~. T.x w~....e.a
» ~II~ I~f `
_=<xr ~ , - - - ~
~ = , , ~ ~~~~a a? `