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Declaration ot Domicile and Citizenship !
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA: ~ '
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This is my declaration of Oomicile and Citizenship in the State of Florida that I am filing this day in accordance and ~
~n conformiy with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of __~or'~?ood ~ liass _
(Ciy) (State)
and 1 resided at -?~1 ~5 Bucloninster Dr. F~owever I have changed my domic.G~e ~
(St~eet and Number)
to and am and have been a bona fide resident of the State of Florida s~nce day of
851
_ . 19_.68..., and I reside at ~ c~ ~~~•4 s~~~port 8t ~oio71---
(Street and Number)
FORT PIERCE, SAtNT lUC1E COUNTY, FLORIOA ~
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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(Inse~t 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.)
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Filing ior homestead ezeaption F~~ED
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT
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~ PIERCE, S~INT LUCIE COUNTY, FLORIDA, permanently.
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~ (Name) B8rbara 3. Fi aher
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~ Sworn to and sub~cribed before me this 20 day of Feb. ~ ~q TO .
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~1C ~~ttk~' ~OlIR* Notary Public '
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By _ D.C. My Commission expires
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(To i~cKu[~i~!"~~;:d~ipltcal~ and origin:l filed with Cl~rk Grcuit Couet, ~nd duplicah with Tax Ass~ssor.)
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