HomeMy WebLinkAbout0934 • ~ ~
Declaration ot Domicile and Citisenship E
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TO THE STATE AND COUNTY TAX ASSESSOR, ~
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Sl. IUCIE COUNTY, FlOR1~A: ~
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This is my declaration of Domicile and ~itizenship in the State of Florida that 1 am filing this day in aocordanos and - ~
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in oor~fOrmity with Chapte~ 222, Section 222.17, Florida Statutes. • `
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I was forme?ly a legal resident of Clinton Corners New YorZ
~~;ty) (State)
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and 1 ~esided at HO110Ut ROad . However 1 have changec! my domitile f
(St~eet and Number) ~
to and am and have been a bona fide resident of the State of Florids since June 16 day of
, 19~~, and I reaide at 419 Cocenu~ A~renuc Rivtr Part
- (Street arxl Number) Ft PierCC
FORT PIERGE, SAINT LUCIE COUNTY, RORl~A
and this statement is to be taken as my declarotion of citizenship, actual lega) residence and domicile in fhe State of Horida.
(Inse~t here any pertinent facts, such as sa18 of p~operty or busineu, or ~elinquishment of employment
at former oomicile, remaval of family to new domicile, purchase of home, ett.)
Declaring residency - with intent to file for
homestead exemptioa
FILED AND RECORDEO
Si. l.UC1E COUNTY, FLA.
-'~=rnRI' VEiitF'r7
'69 OCT 7 1~1 10: 26
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. S\ V J~.. ? 'Ot lINS
CLERK CtRCUIT COURT_
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I FURTHER G'ERTIFY that 1 will oomply with all other requirements of a leyal rosident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
- Ev • -
' (Name) Narold W Robetts
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~ (Address)
. 69
,SvYprti'~pns~ substribed before me this 7tb ~y of ~CtOb!! ~ ~q
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" ~ ~o~r~P+tiKiRas
, ~ ~~CIR~~ COURT Notary Public
gY e~~ d~`'`~ D.C. My Commission expires
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(Te b.:x.art.el in duplia+..nd o.~inal Rlad with a.rk cka~it courf, ana dup~ic.+r with Tax A~..,.o~a
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