HomeMy WebLinkAbout0330 . ~
DeClaratio~ ot Domicile and Citisenship
!O THE STATE ANU CUUNiY lAX ASJEJ~(Uk, .
~~L~,ig~
:;1. IUCIE COUNTY, FIORIDA:
~
This is my declaration of Oomiule and Cit~zenship in the State of Florida that I am filing this day in accordance and i
t
~n conformity with Chapter ?22, Section 222.17, Florida Statutes.
i'v~io5 i3fT8i iji 6 icyoi i t85iu8i G~ `~i~e 1 by - Qh 1 ~ -
(City) (State)
and I resided at i j8 1/2 _North Gamble Street However 1 have changed my domiG~e ~
(Street and Number)
fo and am and have been a bona fide resident of the State of Florida since Aua • 1 _ day of
, 19__?~ , and I reside at _ 3118 O.v-e~h.zOOk DrlV e
Yort St LuCle (Sireet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FlORIDA
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State of Flo~ida.
1
(Insert here any pertinent tacts, such as sale of property or business, or relinquishment of employment
at former dc+micile, ~emoval of family to new domicile, purchase of home, etc.)
Establishing residency and applying for homestead exe~:ption
~
FILED AND RECOROEO~ '
ST. LUCIE COUNTY. RLA.'
RE'C~R~J V Ri~iEO =
~~8
~S'~'
'10 SEP 18 1W 11:35 ~,,~L
ROGER POITRAS
~
CLERK CIRCUtT COURT~
i
~
,
i
I
~
~
€
~ I FURTHER CERTIFY that 1 will comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I infend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FIORIDA, permanently. ~
~ _ G /LjL~Q-Ef ~ K~._
. V ~
~ (Name) i~allace . eyda
~
r
~ - -
(Address)
~
~
a '
~
~
18 September 70 '
Swom to and subscribed before me this day of _ _ . _ 19~ ~
i ~ f
f, ~
i I .
Rp'~ . , - - -
~Q~QURT Notary Public
~
_ ~ ~ g _ ~ - i .
BY _ ` • _ _ D.C. My Commission exp~res -
; . O ~D ~ ~
: ~ E C ; i.
rn ~ a~. _
. R~^~w~i~ ~•~dirp~fut~ and o~ipinai fil~d with Cl~rlc Clrcuit Cour1, •nd dupliut~ with Tax Assissor.) ~
~„''C. C' U ~ '
No t~ ...5~`~ EJJ}~~~~ rrS(,E f~ i