HomeMy WebLinkAbout0884 Declaratio~ ot Domicile a~d Citlzenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE ~OUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in the State of Florids that I am filing this dsy in acoordance and
in tonformity with Chapter 222, Section 222.17, florida Statutes.
I was formerly a legal resident of JefPersonville Ind . i
~ (City) (State) .
Rt `3 . Howevs~ I have cha m domidle
and 1 resided et Y
~ (St~eet and Numbe~) ` `
ro a~d sm and have been s bona fide rosident of the State of Plorids since 1 s t ~y ~
Nov. 6g 116 E Arbor Ave_. ;
, 19 , and 1 ~eside at
(Street and Number) !
i
~
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
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snd this statement is to bs taken as my declaration of citizenship, actual legal residenoe and dumicile in the State of Horida. i
(Inse~t here any pe~tinent facts, such a: sale of propery or business, or rolinquishment ot employm~+~t
at former domkils, romoval of family to new domicile, purchase of home, ~tc.)
' i
Establishing residence and applying for homestead
. ;
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FILED AND RECOROED ~
ST. ~OUNTY, FLA. ~
12t.~.QtZrt ~.C:~t~!-'~~
19p606
- '74 t~~!!R 3 PM 2: yy
i ~~~oa~.,G.c~-L i
V ' :
I ;t, - ` ~ ' ~~T~nS
I C~~RK,CIRCUIT COURT~
I~URTHER CERTIFY thet I will oomply witfi all other requiremsnts of a leyal resident of thls State. `
I FURTHER CERTlFY that I have no intention to retum to my former domicjle, and I intend to remain i~ FORT ~
~
PIEiiCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
~
~ _ ~,~-u- ~
~ ~ ~ (Name) .
a
~ Anne S Aill ( Mrs Gilbert D)
x . ~ (Address)
~ - _
~ ' rc~ 141areh 19_~_.
Sworn to and subsuibed before me this 3 day of
~
~ ~
~ ROGER POITRAS .
~ tIRCUIT COURT Notary Publk
~ ~ .
~ g 4"`"~``'~ ~O~'`~'~ D.C. My Commiuion expires
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~ (To b~ ~x~cut~d in dupliuh and orlQinal fil~d with G~rk Grcuit Couh, and dupliut~ witb Tax AsNS~ora
~ b00K P~b'f UV'~
rio, t 7 . .
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