HomeMy WebLinkAbout0851 D~ciaration ot Domicile and Citi:enship
TO THE STATE AND COUNTY TAX ASSESSOR. 1"73'784
51. LUCIE COUNTY, FlORIOA:
This i: my dcclaration of Domicile and Ctizenship in the State of Florida that 1 em filin~ this day in sooorda~os and
in aonformity with Chapter 222, Settion 222.17, Florida Statutes.
1 wa: formerly a Iega1 resident ot Brookfield I11111oie
(City) (S1ah)
and 1 rosidsd at 3746 Arthur Avenue ~~ve charq«~ my ~omidle
(Street and Number)
to and am end have been a bona fide resident of the Staro of Florida sinoe eTlll~ 10 day of
68 P. 0. Boz ~ 1736
, 19 , and I reside at
(Straet and Numbsr)
fORT M~ SAINT LUCIE COUNTY, lIORIDA
and this statement is to be taken as my declarotion of citizenship, actusl legai reaidenoe and domicile in the State of Horida.
pnsert here any pertinent facts, such as sale of propehy or twsineu, or relinquishment of empioyment ~
at former domicile, mmoval of family ro new domicile, purchase of home, et~c.)
For homeetead ezemption purpoeee '
FILEO AND RECOROED
S7, lUC1E COUNTY. FLA.
R~~~3`?'84~Fo
'69 JAN. t 3 AM I I: 3q
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~ R R POITRAS ,
~ C 'CIRCUIT COURT~ '
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I FURTHER CfRTIFY that i wtll aompiy with all other roquirementt of a fspal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and 1 intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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. . - . . (Na w . O~8 ~
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- ~ ~ =1 ' _ (Address)
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~ T•..• . 3 Januery b9 :
R'SWOin to and w~bsd befors me this 1 th day of , 19 ~
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ROGER lORRAS I
U~ERK CIRCtIfT COURT Notsry Public ~
E
gy ~ . ~.C. My Gommissiort`y~i
pires ~
(T~ b~ ~oawf~d in dupiiesta a~d o~in~l Rl~d whi~ Cl~k Cinvh Couef, and duplkab wilb Tsx A~ora
BOOK 1?5 ~E s4s
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