HomeMy WebLinkAbout1777 ~ ~,4~ . ~
Declar~tion ot Domicile and Citizenship ~ '2~' ~
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TO THE STATE AND COUNTY TAX ASSESSOR, {
Sl. LUCIE COUNTY, FIORIDA: !
}
I
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filiny this day in acoordanoe and ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
Brownsburg Indiana
I was formerly a lega) ~esident of
(City) (State)
i
117 Prairie Parkway i
and I resided at _ . However t have changed my domici~e
(Sireet and Numbe~) '
to and am and have been a bona fide resident of ihe State of Florida since J"Oe day of
_ , 19
68 , and I reside at 219 RiOmar Drive
(Sheet and Number)
fORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal ~esidence and domitile in the State of Horida.
(Insert here any pertinent fatts, such as sale of property or busineu, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
F?lE0
homestead purposes ST. E~ RECORO~p, ~
RECpR~ ~UNT'1; Pl.A!
VERIFIEO
,
'69 FEB 3
p~27' ~
~Ml2~
cIER R °~~as
, K c~RCU~T couRr
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1 RJRTHER CERTIFY that I will comply with all other ~equirements of a leyal resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
r/~~v ~e _ J~a.a,c- _ - ,
(Name) Vivian R. Teal
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3 ~ `
~ - - .~j~' .
~ ~ ~ (Address)
. YY' - ~
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' S~wo~i .fQ and subscribed before me this ~ day of _-~.~'~-l - , 19~
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. R~:-POITRAS ~
~t~CLERK CIRCUIT COURT Notary Public ~
By D.C. My Gommission expirea ~
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(To b~ ~x~cut~d in dupliute snd ori~jnsl fil~d with CIKk CircuH Court, and duplica» with Tax Aa~s~or.)
i
aooK 115 ~
A~E 17'14 ~
No. 13
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