HomeMy WebLinkAbout0781 D~laration ot ~ofnic~~~ and Citis~tshlp 1,~,3,731
TO THE STATE AND COUNTY TAX ASSESSOR,
51, lIICiE COUNTY, FlOR10A:
Thls it my dsclantion of Oomicile and ~tizenship in ihe State of Florlda that 1 am filin~ this day in aooordano~ and
in oonformity with Chapter 2ZZ, Section 222.17, Florida Statutes.
i was fiorm.rlr a ~e~a~ ra~d~nt of Rochester New York
(Ciy) (Sta»)
and I rosid~d at 8~ami Drive . How~ver 1 hsve d?snyed my domicik
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ro a~d am ~nd have bsen a bona fide rosident of ths Ststs of Florida si~oe ~9 1 dey of
, 19 68 , and 1 reside at t o1(~ ii~yal Palm Drive ~ ~
(Street a~d Number)
fORT SAINT LUC~ COUNTY. lLOR~A
and this statarr~t is to be takan as my dacla~ation of citizenship, actual legal res'idenoe and domicile in the State of Horida.
(Insert here any pertinent facta, such as sale of property or business, or relinquishment of employment
. at former domicile, r~noval of family to new domicile, purchase of home, etc.)
Bstablishing residency for homestead exemption
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1 FURTHER CERTIFY Mtiat 1 will oomply with a11 othK rsquirem~nts of s le~al rosidsnt of this Stats.
. .I FURTHEit CERTIFY that I have ra intention to retum to my former domicjle, and 1 intend to remain in FORT
PI~;~~[~T•Lt1C1E_:CQUNTY. FLORIDA, permane~tly.
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: _ (Neme) Paul C. P.loser
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Sworn to and subxrib~d befors m~ this l~th ~y ~ Jaauary , 19~_.
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CLidt C~C11R COi1RT Nota^I Public ~
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6y C.C. My Canmiuion ~xpins ;
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a. ~••~•a1~1 iw ~lic.~. .~i .ei,i~.~ nl~i wNl~ cMrk ciraiN c.w~, .w~ ~Iie.M. wiN~ T.ec A......ra
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