HomeMy WebLinkAbout0576 Decla~atlon ot Domicil• ar~d Citiz~nship
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TO THE STATE AND GOUNTY TAX ASSESSOR,
Si. U1CtE COUNTY. FLORIDA:
This is my declantion. of Domicile a~d Citizenship in ths State of Florida that 1 am filin9 this day in aooordanos qnd
in oonformlty with Chapter 222, Settion 222.17, Florida Statutes.
I w~: formerly a leqal rosident of winet~i Connecticut
(Clty) (Sta»)
and 1 rosidsd at R. F. D. ~l . However 1 hsve chuqsd my domidl~
(Strest and Number)
ro and am and have been a bona fids res'ident of the State of Florida sinoe Jul~ 23 dey of
,~9 6g , and i mside at 1019 Jamaoia Avenne
(Stroet and Number) ~
FORT M~CE, SAINT LIlCIE COUNTY, RORmA ' ~
and this statement is to be taken as my declaration of citizenshipt actual legai residence and domidle in the State of Florida. ~
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(Insert hero any pertine~t fads, such a: sale of property or business, or rclinquishment of emplayment i
at fom~ domicile, removai of family to new domicile, purchase of Fwrr~e, etc.)
Filing ior homeatead ezemption
FIIED aND REC~gRQ~G~,
ST.R~ CIE C0 NTY~btJ1.' - ~
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'69 JAN ~ RM 12: 4
R R POITRAS
CLE CIRCUIT COURT~
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I FURTHER CERTiFY that 1 wiil aomply wHfi all othst requirerr~nh of a lepal rosidsnt of this State.
i FURTHER CERTIFY that I have no intention to retum to my former domicile, and I intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanentiy.
. . . - ' . ~ • ' I
- : ~ Mame) Feliz S. JBamin
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~ , ~ . ' ' ' (AClC~reSS)
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~ 7th Jen. 69
~ Swq~n to and subsuibed before me this day of , 19 ~
~ RO~iER ~ORRAS `
CiERK C.~p11T COURT Notary Public }
1
8y D.C. My Commission expires
tT. b. .oo.aM.a i~ d~pHc.~. ana ort~inal fi~d wi11~ a.~lc c~wiM cow+, .nd ~p~ut~ will~ T.~c A«...ora
BooK 1~5 ~ 574 ,
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