HomeMy WebLinkAbout0225 Decisratio~ ot Domiclle a~d Cltizenshtp
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. luC1E cOUNnr, FIORIDA:
This is my declaration of Oomicile and Ctizenship in the State of Ftorida that I am filinq thl: day in soo~rdanos a~d
in oonfwmity with Chapter 22Z, Section 222.17, Florida Statutes.
I was formerly a legal resident of New York ~ New York
(City) (Stats)
and 1 resided at _ 50-34 F~gD~is Lewis Blvd. ~Baysidt ) ~Wever 1 have charped my domiale
(Street and Nu~nber)
to and am and have been a bo~a fide resident of the State of Fiorida since Jan . 28 day of
, 19~_, and I reside at 114 Soneta ~aurt _
(Street a~d Number)
FORT MEItCE, SAINT LUCIE COUNTY, ROIUDA
and this stateme~t is to be taken as my declarotion of citizer~~~Er, actual legal residence and domiale in tfie State of Horida.
(Insert here a~y pertinent facts, such as sale of praperty or busineu, or ~eiinquishme~t of empioyment
at former domicile, removal of family to new domicile, purchase of home, etc.)
establishing residency for homestead purposes
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1~~~~ j :E.E~ AiJD REG'JP.QED
ST. LUCIE C~UNTY.
RECORD VERlF;~;
J~~ ~n:,~ ~
~o~ER P~;r : ~
- CLERft CIPCUiT COUr~T
1 FURTHER CER7IFY that ! will aomply with all other requiremenri of a lepal resident of ihis State.
1 FURTHER CERTIFY that I have no intention to retum to my former domicile. and ! intend to remain in FORT
I
' PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) Peter Hart
' (Address)
Tth March 69
Sworn.tu a~ su~~Strib~d before me this _ day of 19 .
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~ ~ :Y'0~~.. ~ ' - -
Notary Public
BY r. • ? 'c t~ D.C. My Gommisiton expiras
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(To b~ ax~url~d ir~ duplieat~ and oeiainal fii~d wi11~ Cl~~ic Grarit Couet, and dupti~af~ whh Tax A~s~or.)
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