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HomeMy WebLinkAbout0179 ~ Declaration ot Domicile and Citizenship ! TO THE STATE AND COUNTY TAX ASSESSOR, Sl. IUCIE COUNTY, FIORIDA: ~ ' ( 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. ~ . ~ 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. ` _ i s (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.) ~it3~ Filing ior homestead ezeaption F~~ED ^ qP{ ~T.: ~UCI~ NT~R~EO f ~ p.:~; ;~V ~rFY. F~A ~ i ,~o f l:~cj4~ ~ EB~? p ~ ' 6~~~~- y•~ I 8 ~r~,/ c~C~~" ~~~~U ~ RK ~ ~ 0 ~ c~ Ui~r i f ~ ~ i ~ , : 0 ~ ~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. a ~ I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT ~ ~ PIERCE, S~INT LUCIE COUNTY, FLORIDA, permanently. ~ ~~e~C-d~-'~~l! ~ ~ ~ (Name) B8rbara 3. Fi aher ~ ~ ~ ~ ~s- . l?~-~ ~ ~ : (Address) ~ Sworn to and sub~cribed before me this 20 day of Feb. ~ ~q TO . ~i ~ci J1i .t~ . st~,. .tii~ ~ ~ R~'~Qttt~s 'y; ~ _ ~1C ~~ttk~' ~OlIR* Notary Public ' ~,4 i _ ~ ; . ! y . . _ By _ D.C. My Commission expires ~ _ ~ ~ t. ~ ' ; , . r ~ ~a`r;:^ • ' tif (To i~cKu[~i~!"~~;:d~ipltcal~ and origin:l filed with Cl~rk Grcuit Couet, ~nd duplicah with Tax Ass~ssor.) . ;s~' , ~ ~ t OR NQ. ~a a00K183 PACf z~_~ ~ _ - - ~ - ~ = t. ~ ~2 ; _ ~ ~;~K~. ~ . ~r _ ~ . _ _ . ` ' - . _ o