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acla~atio~ ot Domiall~ and Citi=~nshlp -1~~2
TO TME STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E GOUNTY, FLORIDA:
Thit Is my d~tluation of Dom~cile and Citisenship in th~ State of Horida that 1 am filinp fhis day in aooorda~ ~nd
in oo~formily with Chapter 22Z. Settion 222.17, Ftorida Statutes.
L. I~ New York
I was fiotmKly a Ipa! rosid~nt of
(Ctry) (Stat~)
and ~ rosld.d at 9 Bim Drive, West , Levitt Town _ How.v.r ~ haved,anpsd my domW1.
(Stn~t and Numbat)
to and am and havs been a bo~a fid~ msident of t~ Stst~ of Florida sinos September _ day of
, 19 68 , a~ ~ 806 Bl Rsncho Drive
(StreN and Numbe~)
fORT M~C~, SAINT LUC~ COUNTY, RORIDA ,
and this ststemsnt is to be taken as my declaration of ati~enship, actual le~al rasidenoe and domicit~ in the Staro of Horid~.
pnsert here any pehinent fads, such as sale of property o? businsss, or mlinquishment of employmant
st former domidle, rerrwval of family to new domicile, purchass of horne, ett.)
Establishing zade residency for homestead exemption
RIl.EO AND RECOROEO -
ST, IUCI~ COUN7Y. FLA.
RE QRD VERIFIE~
~~~2
' - '6g JAN .9 IW 9 : 4
i ROG~'~t POITAAS
~ CLERK CIRCUIT COURT~
~
~
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1 RJItTI~ER CfitTIFY that 1 will ao~ly with all othsr nquir~ri of a leyal r~ident of this Sta/e.
-I:FURTHER CERTIFY that 1 fiave no intention to return b my former domicale, and I intend to remain in fORT
g: - f~,
PI~
~r,~1'll~. LiKIE COUNTY, FIORIDA, permanently.
~-v1T ~ C ,
. . •L _ • - b/ ~1~L G.H~ ~ `~7f/1JL b
_ J_;a~~ t`~Y {Name) Frank M. Ferro
: ~ ' { :
3 ' + f' - `
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' t •
. • ^ •-G `y , - (Address)
:
,
'"'r,~ 'Swom to and wbscribed before ms this 9th Jat~uazY , 19 69 .
ROOiR ~OtTRAS
q~RK CIRC{NT Cp11RT Notary Publk
gy D.C. My Gommiuion ~xpires
R~ 1» ~d i~ d~ie.N and oei~inaf Al~d wilh G.elc Ciraiit CaM, aed d~plint~ wilh Tax Asa~~xJ
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