HomeMy WebLinkAbout0311 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformiry with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of R~Ve~sid~ _~al i fnrni a _
~C;ty~ (State)
Brockton StI'eet . However I have chan ed m domiGile ~
and I resided at - - - - - 9 Y ;
(Street and Number) '
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to and am and have been a bona fide resident of the State of Florida since _M8T!~~ _1__ day of ~
:
. 19
64_, and 1 reside at _~_~~~0 1+i ;°e ~
_ Street and Number ~
FORT PIERCE, SAINT LUCiE COUNTY, FLORIDA
~ and this statement is to be taken as my declaration of citizenship, actual tegal residence and domicile in the State of Horida.
(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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Filing for homestead exemption ~
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FILE~ A~~D RECOROE~ . }
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I FURTHER CERTIFY ihat I will comply with al) ather requirements of a legal resident of this State. -
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~ t FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT ~
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PIERCE, SAINT -LUCIE COUNTY, FLORIDA, permanently. , ~ s
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~ ' (Name) Jose e$Fitzgerald
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~ Sworn to and subscribed before me this ~ day of January ~ 19 70
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~j ROGER POITRAS /
CLERK CtRCU1T COURT Notary Public E
~ gy { ~ D.C. My Commission expires
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~ (To be executed in duplicate and original ~iled with Clerk Grcuit Court, and dupliwt~ with Tax Ass~s~or.)
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