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HomeMy WebLinkAbout2068 Declaration ot Comicile and Citizenship TO THE STATE AND COUNTY TAX ASSESSOR, Sl. LUCIE COUNTY, FLORIDA: 's f This is my declaration of ~omicile and Citizenship in the State of Florida that 1 am filing this day in accordance ano in conformity with Chapter 222, Section 222.17, Florida Statutes. I was formerly a legal resident of BR1!ShOte_. ___L~__ I:_ NeW Yor~_ _ ' (City) (State) 45 Bardolier I,ane ~ and I resided at _ _ _ _T . However I havechanged my domiCile ' . (Street and Number)_ to and am and have been a bona fide resident of the State of Florida since DeC__ 4_..__ day of ; 1 - " - - 19~~_, and 1 reside at -~~.,~Q--~823-~OYi~~'~'-9=~a"~------- (Street and Number) FORT PIERCE, SAINT LUCIE COUNTY, FLORIGA and this statement is to be taken as my declaration of citizenship, actual lega) residence and domicile in the State of Florida. (Insert here any pertinent facts, such as sale of property or t5usiness, or relinquishment of employment at former dornicile, removal of family 1o new domicile, purchase of home, etc.) f Filing for homestead exemption 3 ~ Y C ~ ~ I " ~ 'i r tn HPlD f~~CORQED ~ i Lt~•'~~ CQUNT~, F~::. ~ I . " 1~~~~7~~ ~ ~ F ';:l F L~ y i~?~ 3: 5 S t.~,.~ ~ ~ ~ : ~ ~ ; r.:, ~ ~ ~ _ ~ ~ # r~:, •t~ :I,IT CQ!?RT ; B ~ ~ ~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~ ~ ~ } I FURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT a PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ s ~ ~ Y ~ (Name) ml O ~ ZII8 S ~ ~ _ Y ~ 5 ~ (Address) ~ ~ ~ ~ Sworn to and subscribed before me this 4th day of February ~ ~q~_Q ~ - ~ y ROt~ER POITRh~ ~ CLE1tK CIRCUIt. COURT Notary Public ~ ~ 8y t~ D.C. My Commission expires ~ ' . fi.~ ~ ~ ~ . - - ;a~ - . ,r j ~ ' - ~ (To be executed in duplicate and original filed with Clerk Circuit Court, and dupliute with Tax Assessor.) - ~ ~ DOuK1~~ PA6E~UU~ - ~:0 13 < _ " ~ .