HomeMy WebLinkAbout0698 . Oeclaratio~ of Domicile and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IU~IE COUNTY, FIORIDA: ~
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This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filing this day in actwdante and ;
in conformity with Chapte~ 222, Section 222.17, Florida Statutes. ~
I was formerly a legal resident of Reni~ _ Ohio _
(City) (Stata) • ~
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and I resided at ___84~_],Z4~am Drive However 1 have changed my domiti~e ;
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ro and am a~d have been a bona fide resident of the State of Florida since _~gt day of
_ , 19
89 , and 1 reside at 490 SB Verada Av~enue
(Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
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and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. ;
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- (fnserr here ~ny ~ertinent fazts, 3oth as sale of property or business, or retinquishment of employment-%- - '
at former domicile, removal of family to new domicile, purchase of home, etc.)
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Filing ~or ho~estead exea~ption
FtLED ANp RECORDEO
S'- LUC1= COUNTY, F~A_
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70 tdAR 2 AM II: 14 ~
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c~~RK CrRCUr7 COURT'
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~ 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to m former damicjle and I intend to remain in FORT i
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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u (Name) 8ughn P Lewi s
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: Swwn-?o end~~ubscribed before me this -a-~- day of ~rch , 19~_.
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~UIT COU Notary Public
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ey D.C. My Commission expires ~
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(To be executed in duplicsM and originsl filsd whh Cl~rk Grcuit Court, and dupliuN with Tax Ass~ssor.) ~
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