HomeMy WebLinkAbout2062 Declaration of Domicile a~d Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FLORIDA:
This is my declarotion of Oc~micile and ~itizenship in the State of Flo~ida that I am filing this day in aaaxdance and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
I was forme~ly a legal resident of ~~~Q~t Falls WiSCOASin
(Ciry) (Stat~s)
end I resided at 76 w. ~ 143?Z I•ar~ I•ou . However I have changed my domic3le
(St~eet and Number) .
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to and am and have been a bona fide ~esident of the State of Florida sinoe Sept. 1 - day of
, i9~, and ~ reside a~ 342 Naran ja Ave. River ParY
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA -
and this statemant is to be taken as my declaration of citiZenship, actual legal residente and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employma~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
- ~stabEishing residencq for boveat dexe~ption
FILEO ANO RECO~$E~ i
- ST. ~UC1E COUNTY, FLA•
~~~:~01848~2 '
'69 O~T 27 AM 2~
, ~s'~c, C~ ,
; .
' ~ L ^ ~ RCU T COUR7
! CLERK C:
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1 FURTHER ~ERTIFY that 1 will comply with all other requirements of a leysl resident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domitile, and I intend to remain in FORT '
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~ ~ ~ ~
(Name) Jobn w. Pug
(h~-c-~-a~ 'e- i~
(Address) Loretta R. Fugh
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•Sworn~"to'~eni);,subsuibed before me this 27th day of ~tObet ' 19 69.
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• ' ~OGER ~AAS ~ F
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p,ERK COURT Notary Public
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By i 4'~`~ D.C. My Commiu'ron expires
~.rt=!:•5t.u. - •
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(Te b~ ~c~aihd in duplieafa and ori~inal Al~d wHb Cl~eic Cira~if Cour1, and duplieah witb Tax Awa~or.)
t3 BOOK 1~O PACE~O~9
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