HomeMy WebLinkAbout1175 Declaration ot Domicile and Citisenship '
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicilo and Citizenship in the State of Florida that 1 am filing this day in aaordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was fo~merly a legal ~esident of B.~t~n ~OURe ~ _
(City) (Stab)
and 1 resided at _ 128~ Cbe~elle , However I have changed my domitile
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since ~C • 1 day of
_ 19fi9~c~_, and I reside at Ronte 1 Jenstn BtaCh
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citi=enship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, 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 homestead exemption
F~~E~ AND RECOROEOT
ST. LUClE ~pUNTY~
RFCpRD VERtF1ED~A' ~
,T0 JA 188~~8
~ 2 ~ P~ ~ ~ O7
~ P, '017R~S
CIERK CIRCUIT COURT;
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~ I FURTHER CERTIFY that I will oomply with all other requirements of a leyal resident of this State.
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I FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ •~S'~v~'n~ip~ii~id.suts~cribed before me this 2~ day of ~4t111a=a , 19~~..
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~ I.} ROGER.'
~ ~IC, ~1't CUFT.~~COURT Notary Public
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~ By D.C. My Comrreission expires
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~ (To b~ ~xecut~d in duplicat~ snd ori~lnat Rl~d w~th Cl~elc Grwit Court, and dupliuf~ wHh Tax Ass~uor.)
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