HomeMy WebLinkAbout2496 ~
Declaration ot Domicile and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Si. LUCIE COUNTY, FLORIDA: ~
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This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in accordance and ~
in conformity with Chapter 222, Section 222.17, Florida Statutes. ~
1
I was formerly a legal resident ~f - 1~~e~ville VirEinia ~
,
(City) (State)
and I resided at ~ZeYoille Rt. 1 ~-~3 ~Wever I have changed my domiG~e
(Street and Number)
to end am and have been a bona fide resident of the State of Florida since _~~t.amhar day of
_ , 19~_, and 1 reside at ;~z~~~ gt . ~ Bez ~4t
Campbell Road (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 Florida. ~
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(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.)
iiling for homeetead eze¦ptisn
FIlEO AND {
ST. LUCIF C0 ECORDEO` ~
UNTY
c:Fr~?,~(1 VcR!~~~pLA.
189s24
'l0 FEB 10 PM !2: Oz
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;~Qt7R~S
~~`RK C?RCUIT COURT i
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1 FURTHER CERTIFY that 1 will comply with all othe: requirements of a legal residant of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
' ?~~~""^.1~~ %~'L~dGGGC.~~
(Name) g~.~ J. ltatthews
(Address)
~ 3worn~b and subscribed before me this 10 day of ~b~a~ , 19 70 .
r~
. ~ ~ ROGER -,POij~tAi
-CtERK ~CW~-COURT Notary Public
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By , D.C. My Commission expires ~ ~
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(To b~ ~xecut~d in dupliute and ori~inal fil~d with Cl~lc Grcuit ~ourt, and duplfeat~ whh Tax Ass~ssor.) !
~ R 182 ~
aooK 2492 !
~ No. 13
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