HomeMy WebLinkAbout0745 ~
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Declaretion ot Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR, ;
Si. LUCIE COUNTY, FLORIDA:
This is my decla~ation of Domicile and Citizenship in the State of Florida that I am filin~ thia day in acoordanos and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of COlLinibLts Ohio
(Ciy) (State)
and 1 resided at 16?3 Stouder Drive - Rey1101d8buZ'g ~„bWe~er ~ have chanqsd my domidle
(Street and Number)
to and am a~d have been a bona fide resident of the State of Florida since 1s t day of
S~taanber ,~9~, and i ~es~de et 2411 8orth 44th street
(Street and Number)
FORT PIERtE, SAiNT tUCIE GOUNTY, RO~IDA
and this statement is to bc taken as my declaratwn of citizenship, actual legal residenae and domitile in fhe Stste of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employmen~
at former domicile, removal of family to new domicile, purchase of home, ett.)
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Tatablishing re~idence and applying for homeatead
Fl~ED ANO RECORDED
ST. LUCIE COUPJTY, FLA.
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^OiiC :~~Ri=t~D
~ 18832~
'TO JAN 1~I AM IQ : 23
.~~~u~
~c~~:~c? r-ui;~as
CIERK ClRCUIT COURT'
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1 fURTHER CHtTIFY that 1 will oomply witfi all other requi~ements of a legal rosident of this State.
I FURTNER ~ERTIFY that 1 have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
- ,.t.;~:, ~
~ ~ 1 _ .
' . _ . =J ~
. : ' . (Plame)
. - Jo H. Peterson
: . ~ .
~ - l _ (Address) ~
_ ~ . ~
- i
Swom to and subscribed before me this 14th day of January 19 70 . F
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ROGER POITRAS
CIRCUIT COURT Notary Pubiic
BY D.C. My Gommiss+on expires
1To b~ ~x~cut~d in dupticah ~nd oriQinsl Al~d whh CIKIc Cir~a~if Gour~, ~nd duplirat~ wi~b Tax At~a~or.)
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