HomeMy WebLinkAbout0711 t
De~laration of Dor~icile and Citizenship ~
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TO THE STATE AND COUNTY TAX ASSfSSOR,
Si. LUCIE CQUNTY, FLORIDA:
This is my deciarotion of Domicile and Cititenship in the State ot Florids that I am filing this day in aooo~danos a~d
in conformity with Chapter 222. Section 222:17, Florida Statutes.
Tuso• Arisona
1 wes formerly a legal resident of
(Ciy) (Staro)
and 1 resided at 701? B. Calle 1M~rtt . However 1 have cfianged my domidie
~ (Street and Number)
to and am and have been a bona fide reaident of the State of Flarida sinoe NOV. 10 aay ~
, 19 fi9 , and I reside at 153 NB AirnsQ Blvd~
(Street and Number)
FORT PIHtCE, S/UNT LUCIE COUNTY, HORIDA
and this statement is to be taken as my declaration of citizenship, actuai tegal residenoe and domicile in the State of Horids.
(Insert here any pe~tinent facts, such as sale ot property or busineu, or relinquishment of employment ~
at former domicite, removal of family to new domicile, pcrrchase of home, efc.)
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Filing for homestead exeaption
FlLfp a~;~ K~~OROED ~
~T. LUCIE COUNTY, fLA.
~~v~R~ t'ERlF?ED
1882~
'70 J~~ i'I AI~ 9: 4y i
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CL~Fh ~jR~~jT COURT ~
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t 1 RJitTHER CEitTIFY tfiat I wilt comply with ail other raquirements of a IsQal resident of this State. E
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT j
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~ PlERCE, &AINT lGCIE COUNTY, FLORIDA, permanently.
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? , Ma"''e~ osemary Cogosai
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; ~'~:Sworn~~. "a`~~u~crihed before me thi: 14th day of January 19 70
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; - ROGER. -
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E r~. =~RK Cli~l~r~t Notary Public i
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BY ~ D.C. My Commiuion expires r
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_ (To b~ ~x~cuhd in dupltsst~ snd ori~inal Al~d wiTh q~rlc Gnuit Couh, and duplkata wiH~ Tax Aa~s~or.) -
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