HomeMy WebLinkAbout0342 Declaration ot Domicile and Citizenship
TO THE STATE A~10 COUNTY TAX ASSESSOR, ~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Do~nicile and Citizenship in the State of Florida that I am filing this day in acmrdance and
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in conformity with Chapte~ 222, Section 422.17, Florida Statutes. '
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I was formerly a legal resident of ___.~S .CrL1CCS NeW ~7~1C0 _
~C;~y~ (State)
1008 B100IDd81c However I have chan ed m domitile ;
anc~ I resided at - - - - - - - 9 Y
(Street and Number) ?
to and am and have been a bona fide resident of the State of Florida since .~an 1----~ - day of ~
, 19~4_, and I reside at _ 3430 SO. pines Dri~e _ ~
(Sheet and Numbe~)
FORT PIERCE, SAINT LUCIE 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 Florida.
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ;
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at former domicile, removal of family to new domicile, purchase of home, etc.) ;
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Filing for homestead • ~
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F'I.EJ :.~~U ?2ECORDED
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I FURTHER CERTIFY that 1 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 domi~ile, and I intend to remain in FORT a
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
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(Name) Beveriy He~ner
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(Address) ~
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Sworn to and suburibed before me this 7th day of Tanuary , 19 70 . f
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~ ~ROGER PORRAS j
CIRCUR COURT Notary Public
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~ gy ' D.C. My Commission expires
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~ , (Tp bs ~xecuted in dupliuM and originsl ~iled with Clerk Grcuit Co~rt, snd dupliuh with Tax As:~ssor.)
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