HomeMy WebLinkAbout1403 Declaration oi Dornicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
ST. IUCIE COUNTY, F16RlDA:
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This is my deciarotion of Oomicite and Citize~ship in the State of Florida that I am filiny thi: day in acoordanos and ~
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in co~formiy with Chapte~ 222, Section_ 222.17, Florida Statutes. ;
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1 was forme~ly a legal ~e:ident of 08k Park Illinois ~
(Ciy) (State) ~F
829 S outh ElmROOd ~venue ~ ,~r„ever I have chanqed my domivle
and 1 resided at
(Street and Number)
to and am and have been a bona fide ~esident of the State of Ftarids since J8riu8Y'~ 28 ~y o~
_ , 19~~, and 1 reside at 161 B9IIyeTI DZ'iVe .
(Street and Number)
FOAT PlERCE, SAINt lUC1E COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residente and domicite in the State of Hotida.
(tnsert here any pertinent fads, such as sale of propetty or business, or relinquishment of employment
at former domicile, remaval of family to new domicile, purchase of home, etc.) -
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Filing for homestea8 ezemption
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- F~LED ;,p~0 RECOROEO .
S~. 1.UCIC CaUNTY. FLA.
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' _~;K ~1RCUIT C4URT
I FURTHER CERTIFY that 1 will oomply with al) other requirements of a legal're:ident of this State.
; t Ft1RTHER CERTlFY that I have no inte~tion to return to my former domicjle, and 1 intend to remein in FOR7
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f PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
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me) Mary R Burke
P. ~
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dress,
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- S~,t~worn„to and su6scribed before me this l l th day of Ma rch ~ ~ 9 70
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-T ~1~~t~T~C~URT Notary Public
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$/~{~'s; A£ D.C. My Commiuion expires
L~F"-~. .r+~~ j•~-
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`.`~6A+ ~~i~c`~i$f~ in dupltcat~ an~d original filed wtth Ct~rk Cir~uit Cour1, at~d duptiea» with Tsx Assessot.?
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6QOi~i~3 ~~402
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