HomeMy WebLinkAbout2804 Decia~atio~ ot Don~icile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance a~d
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of - We$t P91ID BeBCh Floride
(City) (State)
'S15 ~V31de1^IDere Roed , Flowever I have cha ed m domitile !
and 1 ~esided at - ~9 Y
(Street a~d Number)
so and am and have been a bona fide resident of tha State of Florida since nAml~ar a~1 day of
P. 0. Boa ~
_ , 19~Q., and I reside at Ro11te 2~ 2025 Ft Pi _~r~~ Fl A~
(5lreet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual legal ~esidence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
~Establishing residency for homeatead exemption
FILED AND RECOROED
ST. LUC~E ~ ~F~l
YED`A. '
1g~~60
t69 D~C 30 PM !2 • y3a
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4 CLERK CIRCUIT COURT
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I FURTHER CERTIFY that 1 will oomply with all other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my fo~mer domic,ile, and I intend to remain in FORT ;
~ PfERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ;
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~ c/
~ ( me) e J Joyce ~
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C-
_ (Address)
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'Y •~Sworn to and subscribed before me this 30th day of December ~ ~q 6~ ~
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. -
: ,a' -
- • - ROGER POITRAS
s~ . CLERK CIRCUIT CO/U~RT Notary Public
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E I!/ /Y
~ gy D.C. My f.ommission expires
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~ • . . .
~ , , .
- . v•
- (To bi ~xscutsd in duplicab and ori~inal fil~d with Clerk Circuit Couif, and duplieah with Tax Ass~sior.)
f~ _ BO~~~~ QACF~~?V~ ~
~ No. 13
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