HomeMy WebLinkAbout2864 Declaration ot Damicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FLORIDA: l
This is my declaration of Domicile and Citizenship in the State of Flo~ida that I am filing this day in accordance and 4
in conformity with Chapter 222, Section 222.!7, Florida Statutes.
I was formerly a tegal resident of _ Ar1II8 ~daria lsland Fla. _
(City) (State)
a~~ i ~es~d~ a: y~ i~:,r;ava; { ~a~;~ ~~~ar~y~ :ny ;c.~~:.~3~ -
(Street ar~d Number) '
to and am a~d have been a bona fide resident of the State of Florida since ___-3rd day of ~
_~grnh 19~~, and I reside at , 705 B03tOII 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 he~e 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)
_ FILEO AND RECORDED
S'. LUCI~ COUNTY. FIA.
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1 FURTHER CER~FY that I will comply with all other requirements of a legal resident of this State. j
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I fURTHER CERTIFY that I have no intention to return to my former domiCile, and I intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. y rence 3. POwers
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~~,~~}~',f~Qti:%;;~ 705 Boston~XXXX ~
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~'a ~ T ' (Address)
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r~~~~ Sworri :t+a.~~l s,4ibscribed before me this 16th day of February ~ 19 70 ~
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~ '=kti~' RGUIT COURT Notary Public
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By . ~ D.C. My Commission expires
(To be executed in duplicats and oriQinal fil~d with G~rlc Circuit Coutf, and dupliut~ with Tsx Assessor.)
BOOK182 PacE~~56
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