HomeMy WebLinkAbout0180 Declaration ot Domicile and Citizenship l~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that 1 am filing this day in accordance and
in conformity with Chapter 222, Section 242.17, Florida Statutes.
I was formerly a legal resident of ___~~'~1~~$~ _ ~~8I'io C8Y18$~
(C;ty) (State) '
693 AtheY'ley Road . Howeve~ 1 have cha ed m domiqle
and I resided at - - - - ~?9 Y
(Street and Numbe~)
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to and am and have been a bona fide resident of the State of Flor9da since 8th - day of
November - 6=~~-~es~d~-~:-_- 111_4___ Pine _ Ave-~------ - - -
- (StreP! anc~ N!~m~.+er1
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 Florida.
(Insert here any pertinent facts, such as sate 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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Establishing residence F~~E~ ~:P~D RE~ORDEp
S ~UCIc r0U".TY, F~:.
rn>-;r r~ :
~Xill apply for hom~stead ~
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PIERCE, ,SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ Albert Jone ~
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~ Sworn to and subscribed before me this 5th day of January ~ ~q 74 .
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ROGER POITRAS
~ K CIRCUIT COURT Notary Public
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~ By Q~''4~ D.C. My Commission expires
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(To bs executed in dupliute snd originsl ~iled with Clerk Circuit Court, and duplicats with Tsx Assessor.)
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,3 BOOK1~2 PA6E ~~9
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