HomeMy WebLinkAbout0857 Declaratio~ ot Domicile and Citlze~shlp ~
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TO THE STATE AND CCKINTY TAX ASSESSOR.
ST. IUCIE GOUNTY. FLORIDA:
Thii is my declarotion of Oomiule and Citizenship in the Stste of Florlda that 1 am filirp this day in soo~rdanos ~nd
in oonformity with Chapte~ 222, Section Z22.17, Florida Statutes.
1 was formerly a leqal rosident of BALDWIN • IA~1G ISI.AND NeM Yort
. (Ciy) (Staro)
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snd 1 resided at 28 ChurCh $ttelt , Howevar 1 havecharpsd my domicile
(Street and Number) ~
ro ind am and havs baan a bons fide rosident of the Stats of florld~ :inae a2~d day of
August 19 69, and 1 reside at 220~ Florida Ave.
(Street and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this stateme~t is to be talcen as my dedsretion of citizenship, attual legal residence snd domicile in ths Stste of Horlda.
pnsert here any pertinent fscts, such as sale of property or business, or rolinquishment of employment i
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at formet domicile, removal of family to nsw domicile, purchase of home, etc.)
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Bstablishing residence and a~plying for honestead
FILED AND RECORDED
ST. ~UCIE COUNTY, FLA.
~C!?s; `/ERi~tc7 i
~ 18841~ :
.•70 JAN I 6 A~ ~ ~ 5 , .
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j CL~RK CiRC~1T COURT
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I fURTHER CHtTIFY that I will oomply with all other ~equiromsnb of a legel residsnf of this State.
~ 1 FURTHER CERTIFY that 1 have no intention to retum to my forme~ domi~ile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORI~A, permanently.
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Swo~n to.and subscribed before me this day of aQUar 19
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~ ROGER POITRAS .
CIRCUR COURT Notary Publk
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~ gy ~.C. My Gommiuion expiros
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~ (To b~ ~x~rt~d ie duplical~ and ori~inal fil~d witb q~lc GraH Court, and dupti~ab wita Tax Ass~ora
~ » eooK 1$2 ~ $55
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