HomeMy WebLinkAbout1765 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE ~OUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance a~d
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a lega) ~es~det,r ot ___-_~onroe _ Mich. _
(City) (State)
and 1~es~ded ar ____~~41 _Harborview D. B. ~Wever 1 have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 15th day of
Ald$Lls~___-_-, 19
6~, and 1 reside at ?07 Emil Ave.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facis, such as sale of property or business, cr relinquishment of employme~t
at former domicile, removal of family to new domicile, purchase of home, ett.)
' (Homestead Exemption)
~
RECOROE~.
F1~E~ AN~ ~uNTY~ Fla.
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1 FURTHER CERTIFY that I will comply with all other -requirements of a lega) resident of this State.
1 FURTHER CERTIFY thai I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. R~ChBZ' E Hagen
r
(Name)
707 Emil Ave.
.::l~+~„,,. (Address)
cz••~'~i•t`~ ~t.~FC
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Sw tp,bpd~#ubscribed before me this ~na day of February , ~q~.
- •s~ _ t . ~ 1~Y7~i E. : • '
. ~ ~ ~ PO~S
CI IT COURT Notary Public
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By, ~ .C. My Commission expires
(To be axecuted in duplicate and original filed with Clerk Grcuit Court, snd dupliut~ with Tsx Assesior.)
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