HomeMy WebLinkAbout1147 D~cla~atio~ ot Do~nicfl~ and Citt:~~ship 1'~';3~~;
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, fLORI~A:
Th(s is my declantio~ of Domicile and Citizenship in tM State of florida that 1~m fllinq this day in aooordano~ and
in conformity with Ch~pt~r 222. Secfion 222.17, Florida Statut~s.
Schenettady N• Y•
I was formsrly a leyal resider~t of
(Ciy) (Sta»)
and I resid~d at 86 Elm St]Peet my
(Street and Number)
April 16
b and am and have been a bona fide resident of the State of Florida sinoe day of
, 19 68, and,llreside at 3429 By~coII St7ceet
(Sheet and Number)
?ORT MHCE, SAINT LUCIE COUNTY, ftORIDA -
and this statement i: ro be taken as my declaration of citizenship, actual Isgal re=idenos and domiale in the State af Horida.
qnsen hers any pertinent facts, such as sale of property or business, or relinquishmsnt of employmsnt
at former domicile, renwval of family to new domicile, purchase of home, ett.)
homestead purposes
F1LED ANO REaOR~F~;
ST.RECORD VER~ED
1'739~5
7
'69 JAN . Z~ ~ ~ ~ '
~R R ppITRAS
~LERK C1RCUIT COUR7~
i
I
~
1 FURTHER CfRTiFY that 1 will aomply with atl otF~sr roqvirerr~ri of a lepal r~ide~t of thi: Stat~.
t fURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT J
PIERCE, SAINT LUCIE COUNTY, FLORIOA, permanently.
~ .
' . . Ju e
~ . ' ~ ~ 02 t. ~LS1~- -
(Address) ~ 4
~ . . ~ `
i
"Srvorn b and wbsaibsd before me this 20th ~y ~ January 19 ~9
!OalR rO1TRAf
C~iRK GRCWT COtRT Notary PuWic
Br ~ " O.C. My Commission expi~
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