HomeMy WebLinkAbout1008 1'73891 ~
Declaration o~ Don~icile and Citizenship .
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TO THE STATE AND COUNTY TAX ASSESSOR, ~
51. U1CIE ~OUNTY, fIORIDA:
This i: my decla~ation of Oomicile and Citiienship in the State of Florida that 1 am filing this day in sooo~danoe a~d
in oo~formity with Chapter 222, Section 222.17, Florida Statutes. - ~
i was formeriy a leqal resident of ChampBigti Ill.
(City) (State)
end 1 rosided at 1001 SOUth 1St Street . However I have changed my domiGi~e
(Street and Number)
to a~d am and have been a bo~s fide r~ident of the State of Florida si~ce 7tb day of
November ,~q 68 , and I reside at 2610 South 4th St .
(Streat a~d Number)
Flamingo Motel
fORT ~t~, S~AINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my decla~atiu~ of citizenship, actual legal residenoe and domicile in the State of Horida.
qnsert here any pe~tinent facts, such a: sale of µoperty or business, or rolinquishment of employment
at former domicile, removal of family to new domidle, Fwrchase of home, etc.)
Establish Residency for Homestead Exemption
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fILEO AN~ RECO DE0 _ '
ST. LUCIE OUN~. R~A• '
RFCQ~
~~91 ~
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~69 JAN s AM II: I
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~ R R i'OtTRAS
~ CLE CIRCUIT COURT~
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1 RJRTHER CERTIFY thst I wili oomply with all other requiremenn of a le~aal resident of this State. ;
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1 FURTHER CERTIFY that 1 have no intention ro retum to my former domitile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
Ma'"e~ Chester W. Anderson
(A~dclress)
Sworn to and wbsaib~d befote me this lfith day of ~n~,9 rv , 19~.~.
. ~ , Not~ry Public
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6y . v ~.C. My Commiuion expires
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1Ti M~f~M~•i~.~tal~' aqi Ki~M~I fil~ wiN~ CMuk Cti+aif Cewf. +nd ~licaM wUb Tax At~~~
. ~i75 ~i005 ~
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