HomeMy WebLinkAbout0721 Declaration ot Domicile and Citisenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. NGE ~OUNTY," FtORI~A:-- - _ _ _ _ _
This is my declaration of Domiciie and Citizenship in the State of Florida that 1 am fili~g this day in accordance and
in tonfo~mity with Chapter 222, Section 222.1?, Florida Statutes.
I was formerly a lega) resident of A1b82'1~ _ N@lA YOl"k
(City) (State)
and 1 resided at AlbBYly~ ~elw YOlk'k _____T__. However I have thanged my domitile
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since '78n . 15 day of
,.~9
69 , and 1 ~es~de at 171 Castana Court
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of p~operty or business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, p~rchase of home, etc.)
Filing for homestead eaemption ~
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FrlEp ~ND RECOROEp
; T. LU~1~ CJU;~Ty, F~~. ~
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19G466
2 Pt1 12 ; y 1
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~ CLE?~C CiR~UlT COUnT
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1 FURTHER CERTIFY that 1 will oomply with all other requirements of a lega) resident of this State.
' t FURTHER CERTIFY that I have no intention to return to my former domiGle, and I Utend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. v - Q
_ (Name) Richard Co fey
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~ Swom to and subscribed before me this 2na day of M~TCh ~ 19 70
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~ ROGER PORRAS -
~ CtERK GIRCUR COU Notary Public
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~ By ~f D.C. My Commission expires ;
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~ (Tb 'Y~cutad iet. ~ ' ts and ori insl filed with Ci~rlc Grwit Cou~f and du ieah with Tax Ass~s~.)
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