HomeMy WebLinkAbout1051 Declaration ot Don~iclle and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. lUC1E COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Flo~ida that I am filing this dsy in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of HeM YOrt City NCM YOl~
(Ciy) (State)
and I resided at 6105 97tb Street -~"~iddle ~iliage _~Wever 1 have thanged my domiti~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since VCtOber day of
_ ,~9 69, and ~ reside at 348a Sunsiae Blvd.
(Street and Number)
FORT PIERCE, SAlNT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishme~t of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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, Piling for homestead eae~ption ~ ~
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I FURTHER CERTIFY that 1 will aomply with all other requiremenfs of a legal resident of thia State.
1 FURTHER CERTIFY that I have no intention to return to my former domicale, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) ICathleeD Bal~cer
(Address)
Sworn to and subscribed before me this day of , 19 .
RCIGER PCIT~lhS'.
CLERK GNtCUtT~.CO Notary Public
By . ' O.C. My Commission expires
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(Tb. b~`:eYgQ~t- ~1 dupNcat~ snd oripinal fil~d wjtb GNIc Grcuit Court, and dupliwt~ with Tax Ass~swr.)
, 3 aooK 1U 49
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