HomeMy WebLinkAbout0404 Declaratio~ ot Domicile and Citize~ship
;
TO THE STATE AND COUNTY TAX ASSES.SOR, • i
51. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in acoordance and
im m~formiy with Chapter 222, Section 222.17, Florida Statutes.
I was forme~ly a legal ~esident of __AvOII Lakt _ Oh10 _ ~
(Ciy) (State) ~
4
and I resided at 3324T I.ake ROad _ However I have changed my domivle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since -___?Oth day of
Apri~ 69 225 Airosa Bivd
19_-, and ! ~eside at
ISlree! and
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, adual legat residence and domicile in the-State of Fbrida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, etc.)
3
Establishinq residence and spplying for hon~estead
~
7
F
FILEO ~~30 RECORDED
r- L~~C;= i.OU':7Y~FLA-
, , ~ , ~
_ lggO J~
^~~i-^ •
, s~ 3~ 8 Pt~1 l2 : t 9
. ' .
i ~~~j
;
~~r =K ~~l' i,GL~RT ~
~
~
2
'a
1 ~
~
I FlJRTHER CERTIFY that I will comply with al) other requirements of a legel resident of this State.
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. ~
,
~
' . ~ G . % . - ~ ~~`-~t ~
. ~`c~; ' ~ , 'S~l ~
~ : . . ~ . _ (Name)
r~, ~ ~ Bdgar K. Beil ~
, . ~
~ • -~4,,~..,..f - r~ _
~ ' ; (Address)
.
rs_
~ . ~ >'GG
Sworn to and suburibed before me this 8th day of January ~ 19 70
~ ROGER POITRAS . .
~ K CIRCUIT C URT Notary Public
~
~ By D.C. My Commission expires
~ .
~
(To bs executed in duplicafe and original filad with Clerk Grcuit Court, snd duplicate with Tax Ass~ssor.)
b~
BOOK 1~~ PACE 4O~ ~
~ Mo. ~ 3
' -
.
- - - -
. . : . . W~