HomeMy WebLinkAbout0103 Declaration ot Domi~ile and Citizenship .
r
TO THE STATE AND COUNTY YAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
This is my decla~ation of Oomicile and Gitizenship in the State of Flo~ida that 1 am filing this day in aco~~dance and
i~ conformity with Chapte~ 222, Section .Z22.17, Florida Statutes.
I was fo~meriy a legal resident of New York NBW York
~C~ty~ (Staro) .
and I resided at _ _ 2607 Je]C'Ome AV8 BZ'OIIZ . Hcwever 1 have changed my domiCDle
~ (Street and Number)
to and am and have been a bona fide resident of the State of Florida since 3rd day of
June , 19~, and I reside at 116 Solida Dr. N.E.
' (Street and Number)
fORT PIERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicila in the State of Horida.
(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, purchase of home, etc.)
(Homestead Szemption)
FILEO ANO RECOROE~ _
ST. WCIE COUNTY. F~A.
RECORD V~RiFiED
194323 ~
; '70 JUN 8 PM 12: 59
~ ~ ~i~
ROGER POITRAS
f CLERK CIRCUIT COURT'
~ -
I FURTHER CHtTIFY that I wil) oomply with all othe~ requirement: of a Isyal resident of thia State.
1 FURTHER CERTIFl( that I have no intention to return to my former domiGile, and I intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. p]~ p. G
_ r ~ i~
~ - (Nam
(Address)
Sworn to and subscribed before me this $th day of J~e , 19 •
,`~~~,ti~~~~;i;,s~~tM ~
~ t~ . ~ if~~
~
Notary Public
f • 'a,Z ~
. -
By • ~ ~ _ D.C. My ~ommiuion expi~es
: -
. ~,1'~~: r
~ y : :~r~,,:_:. , ~
(To ~b cah and ori~inal fil~d wiTh Cl~rlc Cirarit Couet, and duplicN~ wkh Tax Ass~or.)
si~•• ' 0 R
t BOOK 185 PA~E 1U4
ryo. t a -
- -k~. ,