HomeMy WebLinkAbout1607 . (
Decla~ation ot Domicile and Citizenship ;
TO THE STATE AND COUNTY TAX ASSESSOR, . !
5~. WCIE COUNTY, FIORIDA: '
~
4
lhis is my declaration of Domicile and Citizenship in the State of Flo~ida that I am fili~g this day in attordance and '
i
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was formerly a legal resident of - Vi118 Grove _ Illinois
(C;ty~ (State)
73 Willow Zene
and 1 resided at However 1 have changed my domicjle
(St~eet and Number)
to and am and have been a bona fide ~esident of the State of Florida :~~xe -~8reh 1 day of
, i9 69 , and I reside a~ 204 Rio Mar Drive
(St~eet and Number)
FOItT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this stateme~t is to be taken as my declaration of citizenship, actual lega) residenca and domicile in the State of Horida. !
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employmant
at former domicile, removal of family to new domicile, purchase of home, etc.)
Homestead eaemption
F ILED RECORO~ 0
~T. LUC1E C~JU~.1~~Fn
u
_ ~~~Zg ~~~:18
'j~ 18~~.~~
:~nt.: ? Vit1
~LF RK C?RCU1T CO
iI
~
~
~
~
I FURTHER CERTIFY ihat I will comply ~rith a!! other res~uirementa of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intenc~ to w~nain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIOA, permanently.
. ~ ~ ,
~ r
(Name) Jean H Ry
(Address)
~rorn to abd,subscribed before me this ~9 day of January ~ 19 70
_ ~ ' . 'y _
~
• ROGHt PO1T1[A`S t
, Gl.EfllE CIItC~#tY COURT Notary Public !
' , 1 • ~ /
gy D.C. My Commission expires _ ~
' . •it.
' `
_ l.~ ~
(To b~ oxecutsd in dupliute and oripinst filed with Clerlc Cirwit Cour~, and dupliat~ with Tax Ass~stor.)
~ r,a. ,s BQOK.~~ ~'Af,~~~
~ ' - - ~ ~
~ e n _ _ - f ~
~ ~ . ~ . _