HomeMy WebLinkAbout0841 acla~atlon ot Don~icil• and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. lUC1E ~OUNTY, FLORIOA: 1`~'3'?"7'S
Thi: i: my declarotion of Domicile a~d Citi~enship in the State of Florida th~t 1 am fitinq thii day in acaordance and
in oonformity with Chaptet 222, 222.17, Horida Statutes.
I was formerly a iegai ~~dent of ~orth Hampton ~[aes.
Kthr) (Sta»)
a~d ~~~dsd at 80 South Main Street, Florence ~ h,~ ~,y ~,~le
(Street and Number)
b•nd sm and have been a 6ona fide msident of the State of Florida since S eptember ~y ~
, 19~~, and f reside at '~l~-.SuR?~#~+ 17+~ S#rRBt
(Street and Number)
FORT SAINT LUCIE COUNTY, ROR~A
and this statament is to be taken as my declarotion of citizenship, actual legal residenoe and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Declaring redeidency for homestead e=emption
FIl.EO AND R~CQRD~b ~ .
ST; ~UCIE CO NTY. LA: ~
~E:COR~ VERIF+EQ
1'73`7~'S
'69 ~!4N I 3 A~1 {0 : 3S
C ~
~ RO R i-f)f'FAAS
CL~R 6lRCUIT COURT
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I FURTF~ER CfRTIFY that 1 will oompiy with all otF~x requireir~ents of a lepal rosident of this State.
I FURTHER CERTIFY that I have no intantion to return to my former domiGle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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.1N~~~~~:~~i~~~~~`~y~`y' .,'',.s.
~ . ~ ~ ' 13th Januery 69
Sworn` ~ii6scri}b~,d b6isxe r~s this day of 19 .
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,jOC~~ = . WOtary P1J~JIit
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~ By ~ ' ' ' C.C. My Commissiw~ ~xpir~s
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