HomeMy WebLinkAbout0722 ~eclaratlo~ ot Domicll~ a~d Citis~nship
1'73~.~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FLORIDA:
This is my daclarotion of Domicile and Ctizehship in ths State of Fiorids Mst I~m filin~ this day in aaoordana and
in aonformtty with Chapter 222. Ssction 222.17, Florida Statutes.
1 was formerly a I~gai rosid~nt of ToledO Ohio
(Ciy) ` (Sta»)
end ~ roslded at 948 Oak St reet , Fbvwvsr ~ Mve charq.d my domkil•
(Street snd Number)
ro and sm and have been a bona fide ~esident of the State of Fbrida since ~ lst day of
November , 19~i.Z, and 1 roside at 128 Se ~th 13th Strp,n#,
(Strost and Number)
l~GRT N~E, SAINT UlCIE COUNTY, RORIDA
and this statement is to be tsken as my dedarotion of ciNze~ship, actusl legal residenoe and domiale in the Sbta of Horida.
pnsert Fiere any pe~tinent facts, such as sale of property or business, or relinquishment of employn~ent
st former domicile, removsl of family to new domiale, purchase of home, etc.)
. Homestead exemption purposes
FIL~O AND RECQRDEO
ST. ~UCIE COUNTY. RLA,
RECORD VERIFIEO
17'3~6`7~.~
'69 JAN FM 2 : 37 '
;
! aocE~~as
~ CLERK CIRCUIT COURT~
~ ~
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I FURTHER CHtTIFY that 1 will aomply with al) other requiremenb of a lepal resideM of this State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicale, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ y
Mrs. me) larence R. Crouser
(Marilyn)
~ .
(/lddress)
~
Swoe,~:,and~wbscribed before me thi: 9th day ~ ,january ~ ~q 69 ,
" ;titi~itu~~iri;;;
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' ~~CIRCUR No1sry Public f.
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8y j' D.C. My Commitsion expires
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