HomeMy WebLinkAbout0055 D laration of Domicile and Citizenship ~
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TO THE STATE AN~ COUNTY TAX ASSESSOR,
Sl. tUCIE COUNTY, FIORI~A:
This is my declaration of Uomiciie a~d Citizenship in the State of Flo~ida that 1 am filing this day in accorderi~e and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
:
1 was formerly a legal resident of a?o~ _ New York
~C~ty~ (State)
and 1 resided at 1~l ler Boad ~ , However I have changed my domicjle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since day af -
_ , 19$~_, and I reside at > ~ •
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA •
and this statement is to be taken as my deciaration of citizenship, aetual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Filing !or hovestead ezemptio~
FtLED AND RECORDED
ST. LI:CtE COUtvTY. FI.A.
. L'E?i~tEE' .
i9Q054
~ FEB ! ~ PM { : 2q /
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¢ ~ i : ~~-t~ws-
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CL~~h ~.R~I.iT COURT '
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I FURTHER CERTIFY that I will aomply witfi all other requirements of a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domic,ile, ar~d I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) Jo~e F ltarino
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(Address)
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~ ~ Swom,ib~~and subscribed before me this ~ A day of ~eb_m~M* . 19--~A•
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~ ~ R0~3[~ PQf~fAS~
- ~~#J~K:CiR~It COURT Notary Public
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gy D.C. My Commission expires
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_ (To b~ ~xecuted in duplicat~ and oripinal ~ilsd whh Clerk Grcuit Courf, and duplicat~ with Tax A:sissor.)
y~ rio. 13 ~ ~LiV ~ ~
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