HomeMy WebLinkAbout1699 Deciaration ot DomiCil• ~and Citisenship
~
TO THE STATE AND COUNTY TAX ASSESSOR,
Si. IUCIE COUNTY, FLORIDA:
This is my declarotion of Domicile and Citizenship in the State of Florida that I am filing this day in aoo~rdanos and
in conformity with Chapter 22?, Section 222.17, Florida Statutes.
I was formerly a legal resident of Detroit l~ich
(Ciy) (State)
and 1 resided at _ 18561 Rivez'vieW , However I have changed my domitile
(St~eet and Number)
to and am and have been a bona fide ~esident of the State of Flo~ids sinoe 18th day of
April ,~9 69 , and I reside at 108 8. 20th St.
(Street and Number)
FORT PIERCF, SAINT LUCIE COUNTY, RORIDA
and this stateme~t is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or busineu, or relinquishment of employme~t
at former domicile, removal of family to new domicile, purthase of home, etc.)
(Homestead Eaemption~
~ ~,fi_
FILEO AND RECOROEO'
ST. ~~CIE COUNTY, FIA.
t.rrnR~ V~R;FfED
18~~~
'10 JA~I 30 AM 10 : 03 •
, M~
~ i~
' rOiTR~S
i CLERK Ctr~CUtT COURT~
~ -
€
~
1 RJRTHER ~ERTIFY that 1 will oomply with al) other requiremants of a legsl rosident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. phf llip Rsy
~ ~
(Na )
~ t,,,~~~~,~.,;,, 108 N. 20th St.
-.j i-i' . ' -
~ ' - C -i Wddress)
. .,,,.......,~C~
~ . . ~ y .r,• : ' ~
; :J`'~2':~ l~= - ~
- ~ r~';'pi;' ' ~ ~i~ . r
^~~~'~-~riirom to ~subscribed before me this 30th day of J~~='Y , 19~.
~
.
. . : , :`i r~sl~ ~ ' ;:Y - '
~ ~l~~.j~. ~
-~~%a~ q • i ~
j.~
f!fC , IT COURT Notary Public
.,,,~f~, ~ ~
By ~ D.C. My Commission expires
(To b~ ~x~eut~d in duplieah and oriylnal fil~d with Cl~elc GrsuH Cou~f, and dupliuh wilh Tax A~swr.)
BOOK1~~ PAGE~~c7~
r,o. i ~ .
~ - . - .
."~e~m`-
~ ?'S - ~ .i, ' - "p ~ T
. SP• ~+e'1 `2KSa ~S.i"d _~?Yy~ . ~ .
+~3'nL r ~