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D~c~aration of Don~icile and Citizenship }
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TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl. LUCIE COUNTY, FLORIDA: ~
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This is my declaration of Domicile and Cititenship in the State of Florida that I am filing this day in acoordance and '
im m~fo~mity ~with Chapter ?22, Section 222.17, Florida Statutes. ~
1 was fo~me~ly a(egal resident of El Paso Te=sa
(City) (State)
10~08 Honolulu Drive
and f resided at However 1 have dtan9ed m; ~bmir,ile
(Straet and Number)
to and am and have been a bona fide resident of the State of Florids since September day of
,~9._69_, and i~eside ar 1121 Pine Avenue "
(Sfreet and Number)
FORT PIERCE. SAINT LUCIE COUNTY, FLORtDA
and this statement is to be taken as my decla~ation of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pe~tinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, etc.)
Filing for homestead ezemption
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I FURTHER CERTIFY that I will aomply with all other requiremenn of e leqal resident of this Stab.
1 FURTHER CERTIFY that I have no intention to return to my former domic.ile, and I intend to ~emain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, p~rmanently. -
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~ (Name) William E Ce1'veT
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(Address) t
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~ ;~3 ~ orti ~ to, and subscribed befo~e me this 3~ day of , 19 .
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f~ ~K-r Q COURT Notary Public i
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~ '~~$y~~• D.C. My Commission expires
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~ Ro~ b~ ~x~cvt~d. in duplicat~ and oripinal fii~d with Cl~rl~ GKUit Court, and dupliuh with Tax Aa~aor.)
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