HomeMy WebLinkAbout2671 Dec~aration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. LUCIE COUNTY, FLORIDA: ~
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and ~
in confarmity with Chapter 222, Section 222.17, Fleri.~r St~tutes.
I was formerly a legal reside~t of -~RiveT GY'OVB I11 •
(Ciy) (State)
and 1 resided at __?6'S6 SpZ'uC6 St2'@6t However I have changed my domiqle
(Street and Number)
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to and am and have been a bona fide resident of the State of Florida since - day of
_ October ~q_ 6~and I reside at _3218 West I~ake Drive _
(Street and Number)
FORT PIERCE, SAINT LUCtE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of propery or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residence and applying for homestead
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FILED AtJD RECORDED ~
ST. LUC~~ ~~U~:TY. FLN.
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. . ~ . 189`758 '
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~ '~n F~~ 12 P`1 i: 56 1
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~ c~rK C':?~:;t~ COURT ;
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~ 1 FURTHER CERTIFY that 1 will comply with all other requirements of a lega) resident of ihis State. ;
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` t FURTHER CERTIFY that 1 have no intention to return to my former domicjle, a~d I intend to remain in FORT :
PIERCE, SAI~f~j~~~UCI~ COUNTY, FLORIDA, permanently. ;
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~ ''`~:'~J (Na -
~ - ; " . : - Ro.bert gendell ~
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~ Pauline K~ 1
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~ Sworn to and subscribed before me this 12th day of Februarv , 19.~Q._.
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ROGER POITRAS 't
~3 K CIRCUIT COURT Notary Public t
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~ By D.C. My Commission expires ~
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,s
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~ (To be executed in duplicste and originsl ~iled with Cl~rk Circuit Court, and dupliute with Tax Ass~ssor.)
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~ r.o. 13 800K PAGE~~6~
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