HomeMy WebLinkAbout2256 Declaration ot Domictle and Citisenship 1~4'~'~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE ~OUNTY, FlOR1~A:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this dsy in eoo~~danoe and
in conformity with Chapte~ 222, Sectio~ 222.17, Florida Statutes.
I was formerly a legal resident of HBNDBRSUN IND.
~C;y~ (State)
and 1 resided at HARDINGS I~pBZLB TRAILEk CRT . . However I hsve changed my domiG~e
(Street and Numbe~)
b and am and have been a bo~a fide resident of the State of florida since lSth day of
August 69 900 Airosa Blvd.
, 19 , and I reside at
(Street and Number)
FORT rIHtCE, SAINT LUGIE COUNTY, RORIDA
and this statement is to be taken as my declaratio~ of citizenship, actual legal residence and domicile in the State of Horida.
pnsert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILING FOR HOMESTEAD PURPOSES
F~LED AND RECOROCD'
. ST. LUCIE COUNTY, F~a`,
~~'CQRO V~RIf~EO
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'69 , fEB 12 PN ! : 23 ~ ~4~'3,2
~ ROGER POITRAS'~
~ CLERK CIRCUIT COURT!
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I RIRTHER ~ERTIFY that I will aomply with all other requireme~ts of a le~al 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.
. ~/i.~%+~lt~' l~
(Name)
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.,,<<~„~~:~~,,.;.. ARTHUR C. MOSCHBNROSS
,t y' ~ (f ldciress)
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_ ~l~`=•('y ~.l ~ .
G'~' 12th Februarq ~q 69
~ ~Svao+w.'to ~?d aubsuibed before me this day of , .
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_:s:, C U COURT Notary Public
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By D.C. My Commiss'~on expires `
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(To b~ ~x~cut~d in dupllcat~ and oripinsl fil~d wiM~ tlKlc qraiit Court, snd duplkat~ with Tax A~a~or.) ~
8~175 ~2Z53 `
Na. 13
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