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HomeMy WebLinkAbout2110 Declaratio~ of Dor~ni~ile and Citizenship TO THE STATE ANO COUNTY TAX ASSESSOR, 51. LUCtE COUNTY, FIORIDA: This is my declaration of Oomicile and Citizenship in the State of Flo~ida that 1 am filing this day in accordance and ~n conformity with Chapter 222, Section 222.17, Florida Statutes. I was fo~me~ly a legal resident of Da> > a~ ~ TpxAs ~~;ty~ (State) 2132 Clarksdale Drive and 1 ~esided at _ . However 1 have changed my domiG~e (Street and Number) to and am and have been a bona fide reside~t of the State of Fbrida since 3].st _ day of ' July _ , t9 ~ and ! reside at 170 Calmosb Drive (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 properry or business, or relinquishment of employment at former domicile, removal of family to new domicile, purchase of home, ett.) 3 1 ~ Establishing resdience and applying for homestead . 3 ' FILED AND ~ RECOROEQI ~ ST. LUCIE COUNTY F ' RECORO VERIF1Ep~A' ~ ,lp 19149 ; ~ Zs ~ i i : ys ~ e r~ocF R ~oirRAs I i CLERK CIRCUIT COURT; i f ! r t - 1 FURTHER CERTIFY that 1 will comply with all other ~equirements of a tegal ~ resident of this Siate. . y 1 FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT ! . . ~ , ` PIERC~, ~Y~~4~~IE COUNTY, FLORIDA, permanently. ~ Si~ ~ . ~ `tit~^.`tG,(~:~el,~.. ~ ~ ~ ,~.j: ~ •;J;_. c• ~ t ~ • ~t ~ y~G''z' •~:~..T.I~.Q,~ # ';.:Y '~'r . f (Name) ~ F Yr~~'`~ - David B. Owen ~ : s ; - ' ' ~ t:: c~ ; -t J ~ '~'rt,~__~ _ ~ ~ ~ _ t~; ~z~= - : ~ . _ _'rX:~ : . ~ . : . (Address) ~ . i ~:~t~ , ` ~ ~ ''~~;,.....y.;.:'. . . ~ Sworn to and subscribed before me this ~5th day of i~erch ~ ~q 70 . ~ ~ R GER POITRAS ~ RK CIRCUIT URT Notary Public ~ ~ ~ gy D.C. My Comm~ssion expires ~ ~ ~ ~ (To be executed in duplicate and originsl filed witlt Glerk ~ircuit Court, and duplicat~ wilh Tax Assessor.) r~~ ° R 183 PA~t2108 BOOK ~ _ . : : ~ ~ ~ _ , 1. E _ ~ ; . . . , _ . ~fz