HomeMy WebLinkAbout1978 a
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Oecia~atfon ot Domicile and Cittzenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in aoocrdance and
im m~formiy with Chapte~ 222, Section 222.17, Florida Statutes. ;
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_ I was formerly a legal ~es~denr of _ Oekfield Me1ne
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(Ciry) (State) '
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and I resided at pYX~YR~I~X However I have changed my domivle
(Street and Number)
to and am and hava been a bona fide resident of the State of Florida since 20th day of i
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_ S@pteIDbe2' , 19
68 , and I reside at 601 SeaM?ay DT. M-28
(Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be taken as my declaration of ciiizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any pertinent facts, such as sale of property or business, or ~alinquishme~t of employment
former domicile, rerrwval of family to new domicile, purchase of home, etc.)
(Homestead Eaemption)
`F1LE0'AND i~ECORQ~~
~ ST.R£CORO VERIF11E0
1913:~E ~
~ 't0 MAR 23 PM : 31
KO~Er~ POITRAS
CLERK CIRCUIT COUl~`ti
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g I FURTHER CERTIFY that I will oomply with all other requirements of a(e~al resident of this State. _
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~ I FURTHER CERTIFY ihat 1 have no intention to return to my former domitile, and f intend to remain in FORT '
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. EdWirle Benn
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(Address)
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~ 23rd March ?0
- Swom to and subxribed before me this day of , i9 .
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~ ,,•.1:stl~lr,f~~,
s Notary Public
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~ By _ , D.C. My Commission expires -
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` ~$°~''y:...~d~ wt~ and ori~inal fil~d with Cbirlc Cirwit Court, and dupliut~ with Tax Aa~stor.)
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.~~~t~nret~~+~~~~ BOOK1~~ PAGE~a7
t No. 13
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