HomeMy WebLinkAbout0448 Oeclaration ot Domicile a~d Citise~ship
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TO THE STATE AND ,GOUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declarotion of Domicile and Citizenship in the State of Florida that 1 am filing this day in aco~rdance and
in conformiry with Chapter 222, Section 222.17, Flc:iab Statutes.
I was formerly a legal resident of BOthell W83h1I1gtOQ
(Ciy) (State)
and 1 resided at - 19220 92Dd Ave. NB , Hc",rever t have changed my domic3le
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 25th day of
Au~ust , ~q69 , and 1 reside at 1909 YOr1t Ct.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual lega) residente and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of properfy or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
i
(Hoaestead Bxemption)
~ . :~.M•~ 4~~tc5 ,
F~LED tiND r?ECORQEp~
~T. LIICIE rQUNTY. rLN.
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188094 '
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~ I RIRTHER CERTIFY that I will oomply with all other requiremenri of a lega) resident of this State. -
~ I FURTHER CERTIFY that I have no intention to retum to my former domic,ile, and I intend to remain in FORT
a
~ PIERCE, SAINT LUCIE COUi~iTY, FLORIDA, permanently. Keitb L. UDdetM/00d
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~ , ~ (Name)
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: _ "sr,_ : 1909 York Ct.
~ : ~ • • - (Address)
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~ ~wg[r~.tb`and subsuibed before me this 9tb day of Jan uarY ~q 70 ,
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= ROGER PORRAS ;
~ IRCUIT COUR Notary Public ~
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By D.C. My Gommission expires
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r~ (To b~ ~x~cut~! in duplieah and oriyinal fil~d witl~ q~rlc qrcuit Court, and dupliuh with Tax Ast~ssora
~ ° R 182 446
y BOOK PhGE ~
~ No. 13 .
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