HomeMy WebLinkAbout0713 D~claratlon ot Dornicil~ wnd Citis~nshlp ~`736`72
TO THE STATE AND GOUNTY TAX ASSESSOR,
51. IIICIE COUNTY. KORIDA:
Thi: i: my daclantion of Domicile and Citi~tnship in ths Stats of Florid~ that 1 am filirp this day in aooo~dano~ a~d
in oonformity with Chapter 22Z, Section 2~Z.17, Florida Statutes.
Jeifsreontown g~•
I wa: formerly a Ipel ~esid~nt of
(CitY) (State)
end 1 ros~dsd at 9g11 Orlendi Court ,~~K ~ have charped my domkile
(Stnet and Numbe~)
to and am and have been a bons fide resident of the State of Florida sinoe neC.. 7 6 day of
, 19 68, and 1 roside at Rt . 4~ BOZ 320
(Street a~d Numbsr)
l~ORT MR~, SAWT 111C~ COUNTY, ROR~A
and this statems~t is b be taken as my dedaration of dtize~ship, actual legal residenos and domiale in fhe State of Horida.
qnsert here a~ pertinent facts, such as sala of property or buainess, or relinquishment of empioymant
at former domidls, removal of family to ~ew domicile, purchase of home, etc.)
s
Eetabliehing residency for hoaeetead ezemption f
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1 RILED ANq RE60ROE0'
ST. LUCIE COUNTY. I~l.q,'
R~CORD VERIFIEO
1'736'?'2
' '69 ~AN 9 PM !2 : I ~
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CLERK IRCUIT COURT;
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~ 1 FURTF~ER G~tTiFY that 1 will oompiy with all ott~ requlr~nis of a lepal resldsnt of this Shte.
1 FURTHHt CERTIFY that I have no intention b retum to my farmer domicjle, and I intend to remain in FORT
~ PiERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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Sworw ~ro ~and wbscribed before me thi: 9th daY ~ Jannary ~ ~ 9 9 f
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ROOER ~OItRA!
CLERK CO~lRT Notary Pubik'
8y D.C: My Commission expires
R~ b~ ~oaarl~d M dvplkab aed o~iDiwai til~l w~ Ci~lc Ci~vM Cew~, and d~pliat~ w~b Tax A~er.~
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