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Declaration ot Domicile and Citizenship ;
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TO THE STATE AND COUNTY TAX ASSESSOR, ~
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Sl. LUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citize~ship in the State of Florida that 1 am filing this day in actordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a lega) resider~t of Carlisle _ Penn
(City) (State)
and I~es~ded ar ___275__Parker Str@@t ~Wever 1 have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since December 23 day of
, 19
69 , and I reside at 2402 Roy81 Palm Dr3ve
(Street and Numb~)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, adual 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.) .
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Filing for homestead ezemption
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FILE~ AND RECORDEO'
ST. LUC~E COUNTY. FLA.
c:r~_~f±~~ E:?tFSKD !
I ! 1888n%: 5 9 ~
~0 J~~d 26 A~~ 9 ,
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'.L, F: f"p!TR:.S ~
CLERK Cir~~Ul~ COU T ~
I FURTHER CERTIfY that I will comply with all other requirementa of a legal resident of thia State.
1 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.
K./ `
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_ (Name) Edward D Stick
' (Address)
".~v??om_tis'at~d subxribed before me this 26 day ot January ~ 19 70
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~ ROGER PO1Tit/i~ : :
, ~ ~ ~~CLERK CIRCqij:~OU Notary Public `
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8y ~ D.C. My Commission expires j
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(To be execufed in dupliut~ and ori~insl ~iled whfi Cl~rk Circuit Court, snd duplicat~ with Tax Aa~ssor.)
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