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Declaration ot Domicile and Citizenship ~
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TO THE STATE AND COUNTY TAX ASSESSOR, ~ ~
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Sl. IUCIE COUNTY, FLORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filiry this day in acto~dance and
;n confo~miry with Chapter 222, Section 222.17, Florida Statutes.
1[i lxankee - _ _ _ _ Wisaonaia
-was-forme?{y a-leaal-resident of - - ~ - . -
~ (City) (State)
a~d 1 resided at _ 3017 No• Booth Street Flowever I heve changed my domiti~e
(Street and Number)
to arrd am and have been a bona fide resident of the State of Florida since -~t~oher day of
- . 19
69 , and I reside at 3~ Sunset Blvd
(Sireet and Number) •
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, adual 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, purthase of home, etc.)
Filing for homestead eze~ption
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. FILEO AN~ R~CORDEO
g~. LUCiE COU~~TY~~LA•
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'Zfl t~t~.R 2 AM 10 : 5
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~ _:i,_:? j•7~Ct.:.~ .
~ ~LCRK C'F'CU1T COURT. _
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I FURTHER CERTIFY that I will comply with all other requiraments of a legal resident of this State.
I FURTHER CERTIFY that I have no inte~tion to return to my former domi~ile, and I intend to remain in FORT
PIERCE, SAINT LUCtE COUNTY, FLORIDA, permanently.
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~ (Name) John Caravella
3
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_ (Address)
~ ~ 2nd 1~arch 70
~ ~ k Sworn to and subscribed before me this day of 19 .
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` " - - '~;~i11T COURT Notary Public
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6y~.; ~ ' D.C. My Commission expires
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~ ~~''(To b~ ~xecuted in dupliub and ori~inal fifed with Glerlc Grcuif Court, and duplicat~ with Tax Ass~stor.)
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