HomeMy WebLinkAbout0590 ~
D~cla~atton of Domicil~ and Citis~nshlp
TO THE STATE AND COUNTY TAX ASSESSOR, -L ~3c~~i
Sl. U1CIE COUNTY, FLORIDA:
Thts is my declantion of Oomiale and Citi=enship in the State of Florida that 1 am filin~ this day in aooo?dano~ and
in oor~formlty with Chapter 222. Sstfion 2Z2.17, Florida Statutes.
I was formKly a I~qal tesident of St LOUiB MiBeo1L i
(~itY) (Stah)
and 1 r~sid~d at 10543 Loo~caway Drive . FbwwK 1 haw charqsd my domidl~ `
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(Stroet and Numbsr)
to a~d am and haw been a bona fide msident of the State of Florida sinoe ~ gt day of
0
nntnber , 19~.~, and I reside at ~ 7,
1? SCl~th tR h Strwet
(Stroet and Number)
FO~T ~CE, ~AINT LNClE COUNTY, RORIDA
and this statan~ent h to bs taken as my dsdaratan of atizenship, actusl le~al residenos a~d domkile in the State of Horida.
prue~t hsro any pertinent facfa, such as sale of properry or business, or rolinqvishment of empfoyment
at former domicile, removal of family to ne~v domiale, purchase of Fwme, etc.)
Establieh Residency for homeatead ezemption
T
,~1~-~~CI~ COUN'~YRp~;~'
RE ORD VERIFI~O
'69 T PM Z : 34
17'3591 ~
ROGER POITRAS
CLERK CIRCUIT COURTi
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1 FURTFIER G~itTIFY that 1 will aomply with all othsr roquiromsnts of a lepal re~dent of this State.
,~J FURTHER CERTIFY that 1 have no intention to retum to my former domitile, and 1 intend to remsin in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permansntly.
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(Name)Zeo D. Wood
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(/~C~feSt)
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Swotn.to and subsaibed before me ihis 7th dsy of Jenuary , 19 69 , ,
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R~ ~OI~AS.
~ p~IC-~WT=EOART Notsry Public ;
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By i D.C. My Con?mission expiras
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R~ b~ ~o~ac~Nd ~ d~plical~ and o~i~inal Rl~d wilh Cl~c Ci~vit Co~h, aed duplkal~ wiM~ Tax A~ora
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