HomeMy WebLinkAbout0159 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA:
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- This is my detlaration of Domicile and Citizenship in the State of Florida that 1 am ~iling this day in actordante and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _ 1NfiST VIRGINIA .
(City) (State)
and 1 resided at BO7i _202!_______ _ _ _ _ _ _ However 1 have changed my domicjle `
(Street and Number)
to and am and have been a bona fide resident of the State of F!o?ida since 14tb day of
~
_ October_ ~q 69 , a„~ i res+de ar 1606 Ha~ana A~e Ft Yierce Plas
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, HORIDA
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 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.)
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F~~ED ~PJ~ RECORDED
~~CIE ~U~:7Y, F!.,~
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Homestead ~ , - •
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1 FURTHER GERTIFY that I wil) 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 domiGle, and I intend to remain in FORT
PIERCE,:S.~II1~T: LUCIE COUNTY, FLORIDA, permanently.
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- MrS.COSBY HAMILTON
' ~ ~ . (Name)
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_
~ _ 1606 Havana Ave. , Ft. Pierce, Fla.
~ _ _ • (Address)
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Sworn to and subscribed before me this Sth day of ~Tanuary , 19~_.
ROGER POITRAS
CIRCU T COURT Notary Public
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~ By ~ D.C. My Commission expires
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(To bs executed in duplicste and original filed with Clerk Circuit Court, and dupliute with Tax Assessor.)
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