HomeMy WebLinkAbout1168 ~ecla~atio~ ot Domicil• a~d Citizenship
1'~'40U2
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E GOUNTY, FLORIDA:
This is my declaration of Domicile and Citize~ship in the State of Florida that 1 am filinq this day in aaoordanoe and
in oonformity with Chapte~ 222, S~ection 222.17, Florida Statutes.
I was forme~ly a legal ~esident of Ne Alban~~ Indiana
(~iy) (Sta») ~
and 1 resided at 1T06 Abbevdale Avenue . However I have chsn~ed my domiCl~e
(Straet and Numbe~)
to and am and have been a bona fide ~esident of the State of Florida sinoe ~ S.t day of
" Se~t . , 19~2, and 1 reside at 132 SB Aldea Court Port St _ Luc ie
(Street snd Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my detlaration of citizenship, actua) legal residence and domitile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
~ .
Homestead purposes
FIt,.ED AND RECaRDED~
ST. LUCtE COUNTY. FLA. ;
RFCOR VERIFIEO
i~'~
'69 JAN 2~,~~2 39
ROGER FO{TRAS
~ CLERK CIRCUIT COURT` ~
~
~ 1
1 FURTHER CERTIFY that I will aomply with all other requlremsnn of a{s~al resident of thi: State. ;
i
1 FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PfERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~
~aR1°~R. T. Haana
~
(Address)
Swor~ to and subscribed before me thi: 2~ dey of Jan u a r y , ~ q 6 9
ROG~R"rpf~s'-
q,ERI( CIR~1Mrt-C~1RT ~ : Notary Public
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B r O.C. My ~ommiuion expiros
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