HomeMy WebLinkAbout0242 Declaration ot Domicile a~d 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 1 am filing this day +n accordance and
in conformity with Chapter 222, Sectio~ 222.17, Florida Statutes.
t was forme?ly a legal resident of Chicago I11. ~
(C~ty) (State) _
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11258 LOfl$M?oOd B@YE t1Cy H111S j.~Wever 1 have cfian ed m domic,ile • i
and 1 resided at - 9 Y t
(Street and Number) ~
15th ~
to and am and have been a bona fide resident of the State of Florida since day of
October 64
, 19 and I reside at 626 'l~exas Court ~
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 Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domic+le, purchase of home, etc.)
Bstablishing residence and applying tor homestead
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FI~ED AND RECOROED
ST. LUCIE COUNTY. FLA.
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'~Q Jnai 6 p~ ~2 ; ~ y
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CI.ERK C'RCUIT COURT~ ~
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1 FURTHER CERTIFY that I 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 domiu~e, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ ~ - . ~ ` ~ (Name) ~
~ ~ ~ ~ ~ : Agnes McNerney
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~ .~5worn to and suburibed before me this 6th day of anuar 7U .
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; ROGER POITRAS
~ K CIRCUIT COURT Notary Public
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By D.C. My Commission expires
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~ (To bs executed in dupliuts snd original filed with Cl~rk G~cuit Court, and dupliut~ with Tax Ass~ssor.)
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dooK 1~2 Pncr 240 -
~ Np. 13 _
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