HomeMy WebLinkAbout1416 O~cluatlo~ ot Don~i~il~ and CItlsMShip ;
TO THE STATE ANO COUNTY TA:t ASSESSOR,
51. lUC1E COUNTY. FIORIDA:
~ Thi: is my declaration of Oomicile and Citi=~nship in !hs St~t~ of Florida tha.t 1 am fili~?q this day in aooordano~ a~d
~n oo~formity with Chapte? 2~2. Section 222.17, Flo~ida Statuta.
I was formerly a legal ~esident of She2'111 New York _
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and 1 resided at _ 215 Hinds AV e. ~~,,,ever I hav~ chanQsd my domidle ~
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to and am and have been a bona fide resident of .tha State of Florida :inee 19 ~ day af ~
_ __Auguet ~q 70 3henuon Dr. Lahewood Park
- . , and 1 rosids at
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FORT r1~CE, SAINT LUCIE COUN?Y, RORIOA ~
and this statement is to be taken as my declsrotion of citizenship, actual legal ~esidence an~ domicile in the State of Florida.
(Inse~t here a~y pe~tinent facts, such as sale of property or business, or relinquishment of employment
st former domicile, removal of family to new domicile, purchase Qf home, etc.) -
. (Ho~estead Ezemption)
=FI~D~AND RECOROED~ •
ST. LUCIE COUNTY.`Fl:A., ;
RECaRO VERIFIEO
19`7385
- '~0 AIfG I 9 AM I~ :10 -
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i CLE K C RCUIT COURT~
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1 FURTHER CERTIFY that 1 will comply with ell other nquirsm~nh af a le~al resident of th1: Sh».
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. CeC~l GOOdBIIOw
f ~`~.i --~~~L~~/ ~Y~-
(Nafs~e)
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~ Sworn to and subscribsd before me thi: 19th . ~y of _ ~~u$t , 19~. ~
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Notary Publit
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