HomeMy WebLinkAbout2398 Deciaration ot Domicile and Citisenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship i~ the State of Flo~ida that i am filing this day in actordance and
in co~?formiy with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of ~a$ti11~8 - On - Hudson New York _
K;y) (State)
and 1 resided at - 25 FOY'Y'e1t AV6. ~~,,,ever 1 have changed my domitile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 18~ day of
_ ____~eptember ,~9
69 , and I reside at 30b5 Pr`uftt Rd.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of ~lorida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead Exemption)
Fi`ED AND RECORDED
`=Y. LUCfE COU~lTY. F~A.
;ir.ttr~~~
" ~.89541
~ '70 EB 9 Pt~ 3:! 3
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~L~~'~ i :~~U1'' COURT
1 FURTHER CERTIFlf that I will comply with all other requtrements of a legal reaident of this State.
1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCtE COUNTY, FLORIDA, permanently.
]~hite
.
(Name)
.,:~ttllt~.~
: 3065 Pruitt Rd.
~~,;+.?j.; ~l~i~~ ~ -
,V ,
N,:~},:. (Address)
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~'~•~f:: r•.., ~ r~' ~ ~ •
:~r. ~`r-
- ' ' ` -~"u:"a th February
_ f~ Svyo~r~,1Q:#~1~` s~l~cribed before me this day of , 19 .
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`~~'rs.. ~ ~tCU1T COURT Notary Public
By ' D.C. My Commission expires
(To b~ ~xecuted in duplicah snd ori~ina! fil~d with G~rlc Grcuit Court, and dupliuh with Tax Asses~or.)
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