HomeMy WebLinkAbout1412 Declaration ot DomiCile a~d Citizenship ;
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. lUC1E COUNTY, FIORiDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
I was formerly a legal res~det,t of _ Indienopolis Ind.
(City) (State)
and 1 resided at __4~5 Woodmer~ Dr. ~„„ever 1 have changed my domiti~e
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida since A~ • ~ day of
_ ,~9
69 , and I reside ar 3125 So. Indian River Dr.
(Street and Number)
FORT PIERCE, SAINT LUCtE COUNTY, RORIDA
i
and this statement is to be taken as my declaration of citize~ship, actual legal residence and domicile in the State of Florida. ~
(Insert here a~y perti~ent facts, such as sale of property or business, or ~elinquishme~t of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.)
Filing for •homestead eaemption
~
, ~
p AND ovN~Y~F A• i
f1L` ~tiE ~.;cF.~~'~o
s1• :co~n ` ~
:~._18~~ . 10
~~O ,~,y 26 p~? 10 • /
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' :.c ~ coURT
CLF P.K C1R ~~I1T
I FURTHER CERTIFY that 1 will cor.~ply with all other requirements of a legal resident of this State.
E
. I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
^
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(Name) V~illiem 1~. White
(Address) ~
26 January 70
Sworn to and s~buribed before me this day of , 19 .
~.4,
. Rov~. ~ORw?s .
~K Notary Public
. _ .
z .
B; ' D.C. My Commission expires
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~(To b~ exe~uted in dupiiuM and original filsd witb Cle~lc Greuit Court, snd duplicsi~ with Tax Ass~stor.)
aooKs~z ~~~410
No. 13
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