HomeMy WebLinkAbout0645 Declaratlon at Domicile and Citizenship
TO THE STATE AND COIINTY TAX ASSESSOR,
51. tUCtE GOUNTY, FlORlDA:
This +s my declarotion of Domicile a~d Citizenship in the State of Florida that 1 am filing this day in aoo~rdanos a~d
in confo~mity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was formerly a legal resident of ~f Otd ~a$ •
(Ciy) ~ t5tsro)
and 1 ~esided at ~AtrY ~te1 . However 1 have changed my domi~ile
(St~eet and Number)
to and am and have been a bona fide ~esident of ihe State of Florida since ~~~l~ SC=tem1~S day of
, 19 69, and I reside at 1714 Wyoming A~enue
(Street and Numbsr)
FORT PIERCE, SAlNT LUCIE COUNTY. RORlDA _
and this statement is to be taken as my declaration of citizenship, actual legal residenoe a~d domicile in fhe State of Horida.
(Inse~t here any pertinent facts, such as.sale of property or business, or relinquishment of employment
at fo~mer domicile, removal of family to new domicile, purchase of home, etc.)
To File for homestead tzenption
FILED AN~ RECOROED
ST. LUC1E COUNTY. FLA.
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'~0 J~« 13 AM 10:02
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~LEPK Cti~~~~T ~OURT
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~ I RIRTHER G'ERTIFY that I will oomply with al) other requirements of a leyal resident of thi: Stats.
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1 FURTHER CERTIFY that 1 have no intention to retum to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) $~gr iK. Bri~tioghal ~
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(/0.ddress)
~ ; Swom to end subsuibed before me this 13 day of January 19 70
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~ ~ROa~. romws
.>y.
~ ~ CLEAK-.CUtCU1T COt~RT ~ Notary Public
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D.C. My ~ommission expires
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(1~O~~,t - in dup{kab and ori~inal fil~d wiib Cl~irlc pra~t Coue~, and dvplieat~ with Tax AsMSaor.)
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: t3 aooK1~2 PACE 643
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