HomeMy WebLinkAbout0926 Declaration ot Dornicile and Citisenship
~ 18846~
TO THE STATE ANO COUNTY TAX ASSESSOR,
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ST. LUCIE COUNTY, FlOR1~A:
Thi: is my declaration of Domicile and Citizenship in the State of Florids thst 1 sm flli~q this day in aaoo~denos and
in oonformity with Chapte~ 22Z. Section 222.17, Florida Statutes.
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I was formerly a legal resident of ~ng IslStld New YorY
(City) (State)
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and 1 ~esided st 14 Pine Place, LindeAhurst , However I have chan~ed my domidle
(St~eet and Numbe~)
ro and sm a~d have been a bona fide ~esident of the Stats of Florida sinos 15th day of
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September 69 340 Melton Drive ,
, 19 , and I reside at
(Straet and Number)
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fORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declarotion of citizenship, actval lega) residence and domidie in ths Stste of Horjda.
(Insert here any pe~tinent fads, such as sale of property or busineu, or relinqui:hment of employment ~
at former domicite, removel of family to new domicile, purchase of home, etc.) ~
Bstablishing residence and applying for homestead
- - FILED AND RECORDED ~
ST. LUCIE COUNTY, FLA.
- ~~COF~: V~R!FIED
.~88469
•70 ~aN E~ ~ 9 : 28
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tiOvE!? ~'OiTR.:S ~ . -
~ CLERK CiRCUIT COURT;'
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1 FURTHER CERTIFY that 1 wil) comply with all other requirements of a Is~el r~ldent of this State.
I FURTHER CERTIFY that 1 have no intention to retum to my forme~ domitile, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FiORIDA, permanently. i
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~ ~ `t`~',;t1t111tf~~.~ ~ ~-'ZCL1~L--!~S? ~
~ - = t, i s~,,~r.'., (Name~ - ~
~ ~ A~exander H. Matz '
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~ ; w.' Jo~a+id subscribed before me ihis 19th day of ~u'1ua ~ 70
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~y .~I..~.1~•~!l~'
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~ ROGER POITRAS
~ CIRGUIT COURT - Notary Publk
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~ By Q~t'~'~ ~ D.C. My Commiuion expi~es
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(To b~ ~x~cut~d Ie dupliut~ sed ori~inal fil~d with q~rk CiKUit Court, and dupliuh whb Tax Ats~sw?J
~ aooK 1$2 ~ 924
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