HomeMy WebLinkAbout0132 Deciar~tion ot Domictle and Cit~:enship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, fIORIDA:
This is my declarotion of Domicile and Gitizenship in ths State of Florida that 1 am filing this day in. soot~rdante a~d
in aonformity with Chapter 222, Section 222.17, Florida Statutes.
I was fo~merly a legal resident of r? H18~L' Indiana
(Ciy) (Sta»)
and I resided at .~11.~ Dp*~+ ~ p n=.i vrs . However 1 have changed my domidte 1
(Street and Number) ~
to and am and have been a bona fide resiclent of the State of florida sirxe Fall of xl~~I of
~(~r_t 29 , 19~l.~, and 1 reside at 4L03 Sn»th Ind; ~n R; op= ~rive
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, aciual legal residenoe and domicile in the State of Florida.
(Insert here any peninent fads, such as sale of propery or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.j
~ Establish Yesidency
~
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t:D~~~`•-n
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~ Si.ZECO~~ VERtF'?~~~, ~ '
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i~~R ~ a+'0~ ~
h:~;;ER PGt~i c::~~ i
CLERf~ C1i;CU~T COU~Zj ~
I RJRTHER CERTIFY that 1 will oomply with all other requirements of a IeQal resident of this Stste.
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. !
~ ~ ~
(Na^~~ Eva I. Bowers
;
~
" (Address) - ~
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~ . ti~• . • ~t ~ , • -
3iewtri:fo a~id;sub~ibed before me this ath day of March , 19~9
.
: _ ' y t~ ~
, •~OOfR= ;*.c_ .
.~~..~~CIRCI~IFC~WtT . Notary Public
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By ~ - D.C. My Commission expires
,
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(~e b~ ~x~aitad in duplicat~ and ai~inal Al~d wilb Cl~ek Gra~it Couh, and duplicah with Tax A~or.)
o K 176 ~E i~
No. 13 _
~ R"`<~.#~~~.;~~~~.,~~'^ _ . - 3s