HomeMy WebLinkAbout1256 Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
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51. LUCIE COUNTY, FLORIDA: j
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This is my declaration of Uomicile and Citixenship i~ the State of Florida that I am filing this day in acmrdance and ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal res~dent of _ _ Norwalk _ Connecticut _
(Ciy) (State) ~
and I ~es~ded ar -1p~onny Brook Dr. However 1 have chsnged my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~Allgll@_~ 6 day of
- , 19~g, and I reside at 2004 Bay Street
(Streef and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIOA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in the State of Ho~ida. ~
(tnsert here any pertinent fads, such as sale of p~operty or business, or relinquishment of employment ~
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at former domicile, removal of family to new domicile, purchase of hame, etc.)
Filing for homestead eaemption
F1~-E~ tiND RECOROED
ST. LUCIc COUNTY, FLA.
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'70 J~ F~ 23 ~I IQ : I 8
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K C1RCUtT COURT~ }
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~ 1 FURTHER CERTIFY that I wil) comply with al) other requirements of a lega) resident of this State.
~ 1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ ~tERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) 8slph gge
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- (Address)
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: 23 January . ?0
S~ :t~ e~d subscribed before me this day of , 19
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~ _ ~ ~~tCU1T COURT Notary Public
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By * D.C. My Commission expires
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~ (To b~ ~xecvted in dupliuts snd oripinal filed with qtrk Circuit Courf, snd duplicat~ with Tax Ass~or.)
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