HomeMy WebLinkAbout0561 Declaration ot Domicile a~d Citiz~nship
TO THE STATE AND COUNTY TAX ASSESSOR.
ST. LUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filinq this day in aooordanos a~d
in conformity with Chapter 222. Sectio~ 222.17, Florida Statutes.
! was formerly a legal rosident of ~~~ke VA
(Ciy) (Stah)
and 1 resided at ~ute a . However 1 heve chsnyed my domitile
(Street and Numbe~)
to and am and have been a bona fide resident of the Stab of Florida since April al day of
_ ,~9 69, and i ~eside at s2A0 Juanita A~enue
(Street and Number)
FORT MERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declarotion of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of p~operty or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
~
~stsbiisbis~ citiz~nahip and reaidenc~
FILED AND RECORDED
ST. ~UCIE COUNTY. F~p,
RE.CO~;~ VFt~1.~i~D ~
1`?"7'8~4
'~9 MAY 5 AN 8: 3
~ 5~
~
; f~ 0 ~ r•OtTRt~S
f CLERK CUIT COURT
~
I FURTHER CE~tTIFY thst 1 will oomply wiffi all other raquirements of a le~al rea'ident of tfiis State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PSERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
ti/.,~-~.
' trvame) Desa ~odges ( Mrs) .
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~
~ (Address)
.,e~+d•
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~to. ~n,d wbsaibed before me this Std day of llt> >q 69
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w %'l • ~VOtary PN~IC
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B~, ' D.C. My Commiuion expires
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,~,.,.,LJ. ~ ~ M d~pWuN aed e~i0in~1 Rl~d wilb Ct~elc GLw~it Cowt, and dupliaN wilb Ta~c AM~r.)
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