HomeMy WebLinkAbout0937 Declaratlon of Domicile and Citizenship ~
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TO THE STATE AND GOUNTY TAX ASSESSOR, !
Sl. WCIE COUNTY, FLORIUA:
This is my decla~ation of Domicile and Gitizenship in the State of ~Florida that 1 am filin~ this day in aooo~danos and
in conformity with Chapte~ 224, Section 222.17, Flo~ida Statutea. ~
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Little Falla NeN Yorl~
I was formerly a legal resident of
(City) • ~a~)
and 1 resided at _ 617 Alba~y St ite t ~~„~ever 1 have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Flo?ida since ~tObe! 5 ~y
(Rio~ar)
, 19 69, and I reside at 115 Cou=t
(Street and Numberj ~
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
and this stateme~t is to be taken as my declaration of citizenship, actual legal residenae and domicile in the State of Florida.
(Insert here any pe~tinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
Bstablishing residencq and ci#izenship
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homeatead exemption purposes FtLEO AND RECORDED'
ST. LUCIE COUNTY. FLA.
F?E COR~ VERIFIED
'69 OCT 71 M~~3 g
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;:OG~R i-OITRAS~
CLERK CIRCUIT CQURT.
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I FURTHER CHtTIFY that 1 wil) comply with all other requirements of a le~al resident of this State.
1 FURTHER CERTIFY that 1 have no intention to retum to my former domitile, and I intend to remain in FORT
PIERCE, SAINT lUCIE COUNTY, FLORIDA, permanently.
• ?
(Mame) Jo Slaughter
v
- . - ~t9f~i palmena Slaughter
_ . (wife)
~ ?th ' O~cto~er 69
Sworri fo a subsa~ed befo~e me this day of , 19 .
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:f.~~:~~;;~:_
; ~C ~.~i1~T N~tary Public
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B a`~ D.C. M Commission expires
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(Ts b~ ~x~cul~d in duplicat~ a~d ori~i~ fil~d with Cl~efc pnvk Court, and duplicat~ with Tax At~or.) •
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