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Declarat~on ot Domicile and Citlzenship
TO THE STATE AND COUNTY TAX ASSESSOR, :
51. lUC1E COUNTY, FIORIDA: s
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in acco~dante and
in conformity with Chepter 222, Settion 222.17, Floride Stetutes.
I was formerly a legal resident of Di~tOD ~~h10 _
(Ciy) (State)
and 1 resided at _~+a97 Blmd41! Dr~~e However I have changed my domivle
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since -~tOber 9 day of
_ _ , 19~4, and 1 reside at NS .larda+ n Read ~
(Street snd Number)
fORT PIERCE, SAINT LUCIE COUNTY, RORIDA -
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Horida. 1
(Insert here any pertinent fads, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Filiag for homeatead eaemption
FILED AND RECORDED~'
ST. LUCIE COUNTY. FLA:'
~ECO ERiFIED
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'70 JAN 2 I AM I I: 0 ~
1
kQ~=P '0lTR~S
CLERK CIRCUIT COURT.;
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I FURTHER CERTIFY tfiat I will comply with all other requirements of a leyal resident of thia State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
~ . ~•-~,~.,t.~ ~ .
~ (Name) JaQes C Kronborg
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~ ~ - .j~ - (Address)
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~ -Sworn to antl'subxribed before me this 21 day of J~Uary ~ ~q TO
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' F ~.~;RO~E~=l~1~Ri?s
_ ~ Ct~11~,~Cd1T COURT Notary Public
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~ By D.C. My Commission expires
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r Ro bs ~xecuhd in dupliut~ and ori~inal fil~d with Cl~ic C'imrit Cou~, and duplicat~ with Tax Ass~sior.)
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