HomeMy WebLinkAbout0220 Declaration ot Don~icile and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my decla~ation of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes. ~
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Cleveland Ohio ;
I was formerly a legal resident of - ;
~~;y~ (Staro) j
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428 Harris Road '
and 1 resided at - However i have changed my domicjle
(Street and Number)
to a~d am and have been a bona fide resident of the State of Florida since Ju~
'SO day of
n (Street and Number)
FORT PIERCE, SAINT lUC1E COUNTY, FLORIDA
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ho~ida. ~
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employment ;
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at former domicile, removal of #amily to ~ew domiciie, purchase of home, etc.)
Filing for homestead exemption
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. FI~ED ~N~ RE~OR~FL.p-
U ~E ~OU~ TY
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I FURTHER CERTIFY that I wil) comply with all other requirements of a legal resident of this State.
1 FURTHER CERTtFY that I ha~~-ie_no intention to return to my.former domicjle, and I intend to remain in FORT s
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ (Nam Lewis . Bosich
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~ (Address) '
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~ ~Swom ~to and subxribed before me this 6th day of January ~ ~q 70
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~s ' ' ~OGHG PORR14S
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~ CLERK.CtRCUIT COURT Notary Public
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~ gy ~ G D.C. My Commission expires
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~ (To b~ ~xecutad in dupliute snd originsl filed with Ge~lc Cirwit Courf, snd dupliu» with Tax Ass~stor.)
~ ~ R ~~2 ~~~E 219
~ Bo~R
Na. 13
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