HomeMy WebLinkAbout1225 Declaration ot Domicile and Citizenship -~~64~34
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUGIE COUNTY, FlORIOA:
This is my decla~ation of Domicile and Citizenship in the State of Florida that 1 am filing this day in actordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
's
Milton _ hew York ~
I was formerly a legal resident of - '
(City) - (State) i
~
i
,Wain St. Y. O. Box 39 ~
and 1 resided at _ _ _ _ _ - _ - - _ - _ - . Howeve~ 1 have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 21St day of
Au ust_ 69 410 Ave. A ~
_ , g - 19-__, and I reside at _ {
(Street and Number) ~
~
fORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ;
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. ~
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead Exemption)
FILEO AND RECORDED
~ S?, IUCIC COUNTY. F~A. :
~:-('f~f~li vFR,~~Fp ~
- 186484 ~
'69 DE~ 3 1~~ I I: 4 8
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:,~~;-i:i~~ ~=OiTr?.:.S
. CLERK Ci?CUIT COUFZT
J
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1 FURTHER CERTIFl( that 1 will comply with all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have no intention to return to my former domiule, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
John Talley Hart
. - - , . (Name
. ~
. ~ . 410 Ave. A ~
,
• . • ' (Address) ~
. . .
_
S~rt~f~b and subscribed before me this 3rd _ day of December , 19~Q_, r
ROGER POITRAS
IRCUIT COURT Notary Public ~
By ~ D.C. My Commission expires ~
(To be sxecuted in dupliute and originsl filed with Ck?Ic Circuit Court, and duplicate with Tsx Ass~s~r.)
saaK181 ~12~4
No. 13
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