HomeMy WebLinkAbout0863 , ~ 1'73'?'~3
De~laratlo~ ot Domi~ile a~d Citiz~~eship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl, llJC1E GOUNTY, FLORIDA:
This is my decla~ation of ~omicile and Ctizenship in the State of Florida that I am filinq this day in scno~dano~ and
in oonformity with Chapter 222. Section 222.17. Florida Statutes.
I wai formsrly a la~al resident of ~arbourville Ky
(~iy) ~ah~
,nd I rosid.d ar 443 So. Irlain St reet „n,
(Street and Number)
ro and am end have been a bona fids resident of the State of Florida sinoe AvA' 28 day af
, 19.11~., and I reside at 1110 SLnr~ ~e B1vdM
(Street and Number)
IrORT N~E, SAINT WCIE COUNTY, RORfDA
and this stata~nent is to be taken as my dedaration of citizenship, actual legal residence and domicile in the State of Horida.~
(I~serf here any pertinent facts, such as sale of property or business, or relinquishme~t of employment
at former domidle, rer»oval of family to new domicile, pu~chsse of home, etc.)
for homestead purposes
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F1LER AN~ RECOR~~~-
- gT. WC1E CVER1~ ED A.
RF ~~~73'~~
*g9 JAN 13
ROGER P RAS ,
~ CLERK CIR UI? COURT:
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t FURTHER CHtTIFY that 1 wlll aomply with all other ~uirements of a le~al rosident of thi: Stats.
I FURTHER CERTIFY that I have no intention to rttum to my former domicale, and I intend to remain in FORT
PIERCE,.~AINT LUCIE COUNTY, FLORIDA, permanently. ~
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. ohn (Name) Fred Pranlc
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c O• Sworn to and wdscribsd bsfore me this 13 day of J an u a rq ~ ~ 9 69
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ROfiER lOITRAf ~
C~ C~IT tOtIRT Notary Publk
t!y ~.C. My Gommission ~xpires
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