HomeMy WebLinkAbout0408 Declaration ot Do~nicil• and Citizenship -
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TO THE STATE AND COUNTY TAX ASSESSOR,
Si. LU~IE ~OUNTY, FIORI~A:
This is my declaration of ~omicile and Citizenship in the State of Florida that I am filing thit day in sooordanos and
in co~formity with Chapter 222, Section 22?.17, Florida Statutes.
I was formerly a legal resident of ChiCagO I111~i1O1S
(City) (Stata)
and 1 resided at _ 3535 W 77id P1aC@ ,~~,,,ever I have chanqed my domic3le
(St~eet at~d Number)
to and am and have been a bona fide resident of the State of Flotida sinte 3 rd cky of
Au~ust ,~q 68 , and I reside at 1604 A Jersey A~e.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of properfy or busineu, or relinquishment of employment
at fwmer domicile, removal of family to new domicile, purchase of home, etc.)
Bstablishing residence and will apply for homestead
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FtLEO ~ND REGOY D ~ ~
S~. LUCIE COUNT t ,
RECORD YERIFIEi: i
1969 r~AR I 2 PM 1: 26
' ROGER POfTRAS
i CLERK CIRCUit COURT
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[ 1'75525
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I FURTHER CERTIFY that { will eomply with all other requirements of a leyal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my fo~mer domicjle, and 1 intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~~tv ~'C~G~ ~ ~%C/
~t~~~} {~~r ~t!iI; ; - (Name)
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'~tt,`= ~a• .t`~'~.~'.~~ - Constance A. Welch
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~ ~ `.•x 12th 1?iarch 69
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_;~:~~:td~,~~ci~iscribed befo~e me this day of -
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ROOER_ ~tiR/15
CIRCUR COURT Notary Public
gy ~ D.C. My Commission expires
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(To b~ ~x~euNd in dupliufa and ori~inal Rl~d wiN~ q~k qrarit Court, aed duplicah with Tax At~stor.) ~
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,3 ~176 ~ 407
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