HomeMy WebLinkAbout0116 Declaration ot Domiciie and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
,
E
Sl. LUCIE COUNTY, FlOR1UA:
~
i
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and i
i
,
~n conformity with Chapte~ 222, Section 222.17, Florida Statutes. i
I was formerly a legal resident of _ _ _ W~S tbUr~__ _ _ _ Np~ York _
(Ciy) (State) ~
800 Oliver Ave. . However 1 have chan ed m domic,ile '
and 1 resided at _ - - - : - - 9 Y
(Street and Number)
to and am and have been a bona fide reside~t of the State of Florida since 14~h --day of
Se~t. ,~q__69, and I reside at ? 2765 - B _
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, ~tt3RiD~ -
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead Exemption)
FILED ~Np i~ECORDEp
S'. LUCIt CQUKTY. FLA.
i' ^.1~~ j~ •w'FL?
2~
'70 ~.~:~'1 S ~M IQ ' 46
~ '7n ~ ~
'i r~:.s
CiRCU1T COURT
~
I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State. ~
~
I FURTHER CERTIFY that I have no intention to return to my former domic.ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently_
Georg H. Fowler
,~i PV ~
(Name)
i
a
2
~ Rt _ 2 2765 *B ~
~ (Address)
~
~ Sworn~to and subscribed before me this Sth day of January ~ ~q 70 ,
~ ~ ~
~ ~
- ,
~ - ~tiER POITRAS
~ CIRCUIT COURT Notary Public
~ By ~ D.C. My Commission expires
~
~ -
Ro bs executed in dupliute and original filed with Clerk Grcuit Couet, and dupliute with Tax Ass~ssor.)
~ ~
~ ~ BOOK PAf,{ ~~,s '
~
No. 13
~ -