HomeMy WebLinkAbout0231 Dsclaration ot Domicil• and Citisenship
t0 THE STATE AND COUNTY TAX ASSESSOR,
ST. LtICIE COUNTY. FIORIDA:
This is my decia~ation of Oomicile and Citizenship in ths State of florida that 1 am fili~p thls day ln aooordsnce and
in oonfo~mity with Chapter 224, Section 2Z2.17, Florida Statutes.
Horseheads New York ~
1 was forme~ly a legai resident of
(City) (Staiej
and 1 resi5led at 708 Ce n t e r S t ree t . Hcwever t have charpsd my domidle
(Sheet a~d Number)
to and am and have been a bona fide resident of the State of florids si~ce _ NOV. 1 ~ .
, 19 68, a~ ~ r~;~ ~ 706 Palm Avenue
(Straet and Number)
FORT PlHt~, SAINt tUC1E GOUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legai residenoe and daniale in ths State of Horida.
(Insert here any pe~tinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family to new domicite, purchase of home, etc.)
~ for homestead purposea 1'7538~
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+o ~
_ ~ 3 n~p
s. ~C~ ~ .
~ n~ ~ amb
= 70 ~ ~,p -
C~ ~ I~C~
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-a- 'v ~2~
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~ I FURTHER Cf~tTiFY that 1 will oomply with all othe~ requirems~tt of a lepa) ~esident of thk State.
t
; I FURTHER CERTIFlf that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, SAINT WCIE COUNTY, FLORIDA, permanently.
~
~ . . :-3`i; ' .
i ;ti~:71:FCf.r • ' ?
~ . ` . • . _ Mame) Harol rry
_ ~ ,
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t . { ~ . - (~lddress)
j~..:_.. .
: ~0'.Slivorn to and subscribed before me this 7th day of ~a~o6~R 1Ka~'Ch 19 G9
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~
s ROGER rORRAS
CLERK CIR IT COURT Notary Pubtic
' By ` D.C. My Commiuion expires
_ tTo b~ ~x~euted in duplicaf~ and ori~nal fil~d wiTh CIKIc Cirwk Cour1, and dvplical~ wHh Taac As~or
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~ , 3 s~ 176 ~ 2~30
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