HomeMy WebLinkAbout0405 i~
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Declaration of Domicile and Citisenshlp
TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. IUCIE COUNTY, FLORIDA: ~
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This is my declaration of Domicife and Citizenship in the State of Florida that 1 am filing this day in accordance and ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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New YorY Cit N. Y.
I was formerly a legal resident of y---- -
(City) (State) ~
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and I resided at 1S1 B. 90th St re! t ~Wever I have changed my domic,ile
(Street and Number)
OctOber 1
to and am and have been a bona fide resident of the State of Florida since day of
, ~9
b9, and t reside at 1 26 N8 Jardain Road, Port St Lucie
- (Street and Number) +
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 df employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Filing for home.stead exemption
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RE~O~DED
F`LEp HND JVt~ Y ~Lr•. ;
,r `~~C1~ -.-t~ ._~1 ~
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, ~ ggoE~o . 2 ~
~~~y 1~ F~1 • ~
1 V ~ 1~~~/ ~ T. P. ~
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~ I FURTHER CERTIFY that I wil) 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 domiGi~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. a
C
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(Na Hu ,J f tey ~
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~ . • 2 ( ress) ' ~ ~
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- Swbrn to. arrd suburibed before me this 8th day of Januarv ~~q ?0
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~ " ~ . ~ ROi~ER POIt'RAS ~
~ CLFRK Cl~~t COURT Notary Public
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By G O.C. My Commission expires
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(To bs executed in duplicate and originsl filsd with Clerk Grcuit Cour~, and dupliwte with Tax Ass~sso~.)
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~ soox 182 PAGE 403 ~
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No. 13
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