HomeMy WebLinkAbout1148 Declaration ot Domicile and Citisenship ~
TO THE STATE AND COUNYY TAX ASSESSOR,
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Sl. lUC1E COUNTY, FIORI~A:
This is my declaration of Domicile and Citizenship i~ the State of Florida that I am filing this day in eco~rdanoe and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
1 was formerly a legal resident of ~cotb Ill. _
(City) (State)
330 Baat Grant Street
and I resided at - . However 1 have changed my domiCi~e
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since ~~b• day of
_ , 19
69, and 1 reside at ~ut! 2~ BO][ 3703
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and fhis 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 relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
Piling for homestead exemption
FILED AND RECORQED
ST. LUCIF ~QUNTY, Fl.N. `
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188~48
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C~ ~RK •C+R^i.,~!T ~`pIJRT
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~ I RIRTHER CERTIFY that I wil) comply with all other requirementt of a legal reaident of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUUE COUNTY, FLORIDA, permanently.
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(N )Jo 3 Yeast
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~ ' ~ - Z1 Jsnuary To
~ Sworn to end suCncrJbed before me this day of , 19 .
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~ . ROGER ~PDI~RAS:
~ CLERK_~IR~~:,QptIRT Notary Public
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~ By _ D.C. • My Commission expires ;
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~ (To b~ ~xecuted in duplicate and oriqinal ~il~d with Cl~elc Grwit Court, and dupliwt~ with Tax Assos,~or.)
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~ BoaK~.~2 ~~~~~46
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