HomeMy WebLinkAbout1090 !
Declaration ot Domlcile and Citizenship ~
TO 1HE STATE AND CDUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FIORIDA:
This is my declarotion of ~omicile and Citizenship in the State of Flfl~ida thst I am filing this day in aoto~dance a~d ,i
~n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
_
I was fo~me~ly a legal ~es~denr of Jackhorn Kentucky
(Ciry) (State) '
and 1 resided at ~~~~~~~~a General Del . , However 1 have changed my domi~ile
(Street and Number)
to and am and have been a bona fide resident of the State of florida since ~7th day of ~f
{
December , ~9 69 , and I ~eside ai 338 Fla. Ave. ~
(Street and Number)
~
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA ;
,
~
and this statement is to be taken ~s my declaraYwn of citizenship, actval legal residence and domicile in the State of Horida: ;
- r
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of .employment ~
at fo~mer domicile, removal of family to new domicile, purthase of home, etc.)
.s
,
.i
.
(Homestead Eaemption) ~ _ i
F~~ED AND RECORDED
ST. LUCIE pUNTY. FLA.
c
~?~'Eo
' . 'lo 5 194'?'S0 ~
' P~ 2 : 40
~
~ ~:r? : p. ;
!
C~=RK CtRCvIT COURT
~
t
~ 1 FURTHER CERTIFY that 1 wi{I oomply with all other requirements of a legal'resident of this State.
~
~ I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanenily. Sy1Va11 HII11
'Fs
f
A
~
~
Y (Name)
~
5
S
i
= 338 Fle. Ave.
~ (Address)
'i
' Sth March 70 ~
} Swom_; to, and suburibed before me this day of , 19 . ~
,,,:~,~~.n•; : ~
~ ~ • , ' ~ ~
, , r~~t,. . !
~ ' ~ ~
~ ~~r~Cr~~~ eOlTw~?';~,ti= ;
F
- _~t~R CUIT~~IA!} Notary Public ~
= ; . ' i
- . -
~ , ~
- ey - D.C. My Gommission expires ;
_ :
~ ~IF'.~ ' E(~ - :
~ . ~ ' . ~
'r~~• •.~~~V
/J ~ ~
_ (1`a~~+ox ,,i~`duplicate snd oriqins! fited with Cle Court, and duplicat~ witb 7au Ass~ssor.)
- • . 0 R PACE 1~~a7
~ 800K
~ . - _ .