HomeMy WebLinkAbout0609 O~ciuation o! Do~nicil~ ar~d Citis~nship ,1"~~Q4
TO THE STATE ANO COUNTY TAX ASSESSOR,
51. lUC1E COUNTY. FlORIOA:
'~~~is 1s my declaration of Oomitile ~nd Citist~ship In ths State of Horida that I ~m filin~ this day In aooorda~a ~nd
in oonfamity with Chapter 22Z, Section 2~Z.17, Florida Statutes.
1 was iormKly a(e~sl nsid~nt of HaaoIId IIIdi911a
Kity) (Sta»)
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and I ns~d~d at 3145 163rd Plaas my
(Strest and Nv~)
ro and am and haw bsen a bona fide msident of the State of Florida sinae 1[~ day of
, ~q 68 , a~ i~~ ~ 181 Bansan i~ Drive
(Street a~d Number)
~'ORT NERCR SAWT LIKIE CONNTY, RORIDA ~
and thi: statsmsnt is b be taken as my dedaraYwn of citizenship, actval iega! residenoe anc! domiale in ths State of Horida.
pnsert here sny pertinent facfs, such a: sale of propsrty or business, or ~elinquishment of employment
at former domicile, romoval of family to new domiale, purchase of horr~e, etc.)
Filing for homestead ezemption ~ `
fiLEO ANQ R~-C~sQ~ ~t„
ST. LUCi~ COUNTY:~•
R~CoRO vERI~~E
- 1`73604
'69 JAN e AM 9' g6
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RQ~ ITRAS ~
~ CLERK ClRCU1T COURT~
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1 FURTHER CfRTIFY that 1 wili aomply with ail o~ r~quir~nb of ~ lepal roslde~t of this Stat~.
1 RIRTHER CERTIFY that I have no intention to return to my forme~ domicile, and I iniend ro remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permane~tly.
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~ ~ ° tName) FranY T ogue
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,
~ . - , - _ (A~ddns:) ~
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~ ' ~ r ` . _ 1
~ ~ • • 8th January 69 ~
~Q~ind wbsuib~d befot~ me tfiis d~y of 19 . '
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lOOt /OiTRAt
CIYK pRqNT COURT Notary Pubik ~
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O.e. My co~~o~+ .x~s~ ~
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R~ M~N~ i~ i~ikw a~i «yiMl pwi wNlr Cl~k CMwM Cw~, a~i ~IiaN will~ taac Aww~.1
i7~ ~ 60~
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