HomeMy WebLinkAbout0898 O~cla~ation of Domicile and Citi:enship 17382~
TO THE STATE AND ~OUNTY TAX ASSESSOR.
Sl. LUCIE ~OUNTY, FLORIDA:
Thi: is my declaration of Domicile and Citizenship in the State of Florida that 1 am fili~g this dsy in acoo~danoe and
in aonformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Herkimer_ New York
(Ciy) (State)
and I msidsd a~02 11TOtth WgShi n$~nn St, . However I have changed my domlcjle
(St~eet and Number)
to and am and have been a bona fide resident of the State of florida since 22IId day of
March , 19~L~, and 1 reside ai 2102 Delaware Ave
(Sheet and Number)
FORT ~CE, SAINT LUClE COUNTY, RORIDA
and this stateme~t is to be taken as my declaration of citizenship, actual legal residence and domicila in the Staro of Ho~ida.
qnsert here any pertinent facts, such as sale of p~operty or busineu, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Applying for Homestead Exemption
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FIL.E~ ANO REC~RDED~
COUNTY• FI.A.
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•~g J~~ 14 AM 10
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~ CLERK ~~RCV1T COURT
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I FURTHER CERTIFY that I will oomply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiG~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
Y . Ct~'l
(Name) hn V. Fagan, Sr.
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~ (Address)
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Swor~ to and :ubsuibed before me this 14th day of .]anuary , 19~9
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ROOE~ !Qf?~AS~ •
Ct~R1('C~WT G~l1~T~ Notary Public
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By D.C. My Commission ~xpi~es
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(T. r..~:wl.~ ~iw~'ati~icil:~~ 1i1~ ,wi1b u..k a~arN c.w+, .ea auplic.+. u?iM~ Tax Asi.«.ra
~ . ~ ~i75 ~ 896
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