HomeMy WebLinkAbout1151 Deciaration ot Domicile and Citizenshlp _
TO THE STATE AND ~OUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORI~A:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and-
im m~formiy with Chapter 222, Section 222.17, Florida Statutes.
Tsmpi ~ Florida
I was formeily a legal resider~t of ,
(City) (State)
3
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and I resided at 4104 ~l1i0 w~?e , Hcwever I have changed my domicjle ~
(Sireet and Number) I
to and am and have been a bona fide resident of the State of florida since ~t~~r day of
69
_ , 19 and 1 reside at 100~ Nebrasl~a A~e.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(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.)
Filing for hoaestead eae0ptios~
i
F~LED aN~ RECOROED
; T, l'+JCIE ~QUNTY. FL:..
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- 1~~50
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' C~~RK C:RCIlIT COURT
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a leyal resident of this State.
t 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.
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(Name) PranCCa i?~ ~OburII
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(Address)
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~ Sworn to and subscribed before me this 21 day of Janussy ~ 19 70
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~ '~ROG~R_!OI'IEI?S
, ~ `CL~It•:~ERCU,f#'~OURT Notary Public
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~ By = ' " ' , _ D.C. My Commission expires
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: .•.,;,-(~1~ b~ .~c~tu~~d _
i~' dupliut~ and original filed with q~?k Urcuit Court, and duplieat~ with Tax Ass~stor.)
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