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HomeMy WebLinkAbout1290 Oeclaratio~ ot Don~i~il• and ~itttenship -~~4a8~ _ TO THE STATE AND ~OUNTY TAX ASSESSOR, St. LUCIE COUNTY, FLORIDA: This is my declaration of Domicile and C+tizenship in the State of Florida that 1 am filin~ this day in aooo~danos and in aonformiy with Chapter 222, Saction 222.17, Florida Statutes. ~ 1 was forme~ly a legal resident of INDIAN~POLIS IND. (Ciry) (Sta») and t resided at 3 331 F e rdc li f f AvC . ~We~ ~ h~ve cha~ped my domic3le (Street and Number) to and am and have been a bona fide resident of the State of Fiorida since Tt h dsy of December 68 ?39 Altura St. ~ , 19 , and I reside at (Street snd Number) FORT PI~KE, SAINT LUCIE COUNTY, FtORIDA and this statement is to be taken as my declaration of citizenship, actual legal residehce and domicile in the State of Florida. (Insert here any pertinent facts, such as sale of propefty or busineu, or relinquishment of employme~t at former domicife, removal of family to new domicile, purchase of home, etc.) f~ling for howestead purposes FILEO ANO RECORDED ST. L.UCIE COUNTY. FLA. -~~Z! l RIFlEp -'69 JAN 23 AN 10: 02 S.~ R~~Ei~O~TRaS C~ERK CIRCUIT COURT 'j t I ~ ~ 1 FURTHER CERTIFY that 1 will oomply with sll other requirements of a le~al rssident af fhis State. F f 1 FURTHER CERTIFY that I have no intention to retum to my former domitile, and 1 intend to remain in FORT ' ; t PIERCE, SAINT LUCIE COUNTIf, FLORIDA, permanently. , , . " _ • _ . • sj _ au~ MAxGp,~lsT B1J.EN WjsBB - . . : , . ~ : : (I?ddress) ~F 23rd ~ANUARY 19 69 Swom to and subscribed before ms this day of - RO~iER CONRT Notary Public gy ` O.C. My Commitsion expires Q~ b~ M drpNcN~ awd ~ei~inal fiMd wNl~ CM~Ic CMaAt Gwt. aw~ drpkcal~ wiN~ Ta~c Aw~~.1 ~i?5 ~iz8? ~ ~ ~ , ; - .~i ` - ~ + r~ ~y, _ k.b ~ a