HomeMy WebLinkAbout0812 1~3~52
D~cla~ation ot Domi~fl~ a~d Citis~nship
TO THE STATE AND COUNTY TAX ASSF550R,
51. ltJC1E COUNTY, FIORI~A:
This i: my declsntion of Oomicile and Ctiu~+ship in th~ State of Horida that 1 am filin~ thls day in aooordano~ ~nd
i~ oonformity with Chaptsr 222, Sectio~ 222.17, Florida Stahites.
~ was form.r~y a ~eqa~ r.s'~nt of 1~ashf agton D. C.
(CItY) (St~h~
and 1 naid~d at 5318 42nd Street N_ W. . Fbwever 1 haw dwrp~d my domWl~
(Stnet and Numb~r)
ro and am and have been a bona fids rosident of ths Sta» of Flaida sinos 23rd day of
September ,~9 6~, a~ ~ rosi~le a,t Rt 2 Box 2746 * Lakewend Park
(Street and Numbsr)
Pt. Pierce, Florida
ro~ heecE. s~a~ ~uct~ cou~rt~r, ao~~?
and this staibmsmt is to be taken as my dsclaration of atirenship, actual legal residenos and domicile in the State of Horida.
pnssit hero any perti~ent fach, wd~ as sale of propsrty or business, or mlinquishment of employment
at former domicile, rsmoval of family to nsw domicile, purchase of horr~e, etc.)
Homestead Purposes
~ flLE~, A D RECORO D
sT~ ~UQI~COUNTY. ~LA.
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Ft ~ C Q F?1~1 f~~S-~~iG
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'69 JAY 10 P~1 : I 8 ~
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R ER POITRAS
CLERK CIRCUIT COURT
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~ 1 RJRTF~ER CERTIFY that 1 will aomply wHfi all oHx~ nqui~h af a ispal ~t of tfib State.
1 FURTHER CERTiFY that I hsve no intention ro retum to my former domic~le, and I intend to ramain in FORT
PIERCE, SAINT WCIE COUNTY, FIORIDA, permsnenNy.
C~G!LC~ ?
ari J. Metzei
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R (Address)
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S~w~orn b and wbx~ib~d befor~ me thi: lOth ~y ,january , 19~_.
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