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Declaratio~ ot Domicile a~d Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
S~. LUCIE COUNTY, FLORIDA:
This is my declaratio~ of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and ;
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in conformity with Chapte~ 222, Section 22~.17, Flo~ida Statutes. '
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I was formerly a legal reside~t of _ BOwie ~d • _ ~
(C;ty) (State)
and I resided at ?5 ~
3 Remmerton L811e ~~,,,ever 1 have changed my domi~ile
(St~eet. and Number)
to and am and have been a bo~a fide resident of the State of Florida since ~8Y ~ day of
, 19 69, and I reside at ~ ~ ~0 Sunrise B1Qd.
. (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be t3!cen as my declaration of citizenship, adual legal residence and domicile in the State of Horida.
(Inse~t 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 homestead ezemption
FILED ~N~ RECORDED
~v~{~ •::OUPJ7Y. FL:>.
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. 188~~~~
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t"'i 29 ~.M 4~ ~ US
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r~_~'KK,~1R~'~IT ~O~~T
I FURTHER CERTIFY that 1 will comply with all other requirements of a(eyal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend fo remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORfDA, permanently.
(Name) Sue V. Evana
(Address)
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,~_.Swp~n ta,and subscribed before me this ~9 day of Jenuary ~ 19 '70
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• ROGER`~ ibIT1~AS _
~i~Ct~lt COURT Notarf Public
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''~y - ~ D.C. My Commission expires
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(To b~ ~x~cuted in duplicat~ and ori~inal filsd witk Cl~rk Grwit Court, and dupliut~ with Tax Ass~or.)
BQOK~~ .
No. 13
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