HomeMy WebLinkAbout0942 Declaration ot Domicile and Citizenship
TO THE STATE AN~ COUNTY TAX ASSESSOR,
5T, lUC1E ~OUNTY, FLORIOA:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filinq thit dey in aooo?danos and
in oo~formity with Chapter 22Z, Section 222.17, Flo~ida Statutes. _
Bluefield West Va
1 was formerly a legal resident of
(Ciy) (State) ;
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and 1 resided at Route 3, ~_Boa 668 , F{owever 1 havechanged my domicGle
(St~eet and Number)
ro and am and hsve been a bona fide ~esident of the State of Flaids sinoe July dsy of
, 19 69 , and I reside at ?09 ~il Ave .
(Street and Number) ~
,
FORT PIERCE, SAIN? LUCIE COUNTY, RORIDA
and this statement is to i~e taken as my declarotion of citizenship, actual legal resi~anos a~d domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or busineu, or relinquishment of employment
at former domicile, removal of family ro new domitile, purchase of home, etc.)
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Filing f or homestead ezemption
• FILED aND RECORDED
ST. LUCIE COUt~TY. FL:..
i~...~^atJ ~~r`~~~ ~r . -
188483 ~
'70 J~"~ I 9 A~I I!: I 9~,~,~
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~ ~:rJ;;Fi? i'Ot i R,".S
CLERK C1R~llIT COURT
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~ I RIRTHER ~ERTIFY that I will oomply with all othe~ requiremenri of a Ispal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to ~emain in FORT
PIERCE, SAINT lUC1E COUNTI(, fLQRIDA, permanently.
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~ (Name) Garne Flippen ~
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, - -
c ; . . (~?ddress)
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: 19 January 70
~ ',~yvom to:~~i~• subxribed befwe me thi: day of 19 .
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z , ~a
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~ ~ :~;~iE~~~U~CUlT COURT Notary Public
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~ By D.C. My Cwnmiuion expires
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~ (To b~ ~x~cuhd in duplicat~ and ori~inal filsd witb qak qrcvH Cou~t, and dupliea» with Yax Ass~ssora -
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~ r~. ~ a e00K ~0~., PACE ty4~
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~ ~FY- _+ya4
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