HomeMy WebLinkAbout0299 Declaratlon ot Domicile and Citizenship
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TO THE STATE AND COUNTY TAX ASSESSOR, `
2Q0~35 '
Sl. lUC1E COUNTY, FIORi~A:
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This is my declaration of Domicile and ~itizenship in ths State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 22?.17, Florida Statutes.
I was formerly a legal ~esident of ~eTp1811Ck N@w York _
• Kiry) (State)
and 1 ~esided at _~~•___BOZ_ 441, ~187cteII ~ 8 YObile Home _Pk. _ ~Wever I have changed my ciomic3le
(Street and Number)
da of _ ~
to and am and have been a bo~a fide resident of the State of Florida since 1 th y i
p 136 Liberty way, Bt. Pierce, Fla.
--ZZil'1~ - - - - , 19 ? and 1 reside at ~
- (Sfreet a~d Number) +
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FORT PIERCE, SAINT WCIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
Homeatead . i~~ QRE~~ -
QOOEN ~TR
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REC~OREO VE~qRIP1E~d~.i:~c~
Nor 9 2 ~9 PM'T8
2~0063~
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1 FURTHER CEi~TIFY that I will comply witk all other requirements of a lesa) raaident of this State. ~ "
I fURTHER CERTIFY that I have no intention to return to my former domiule, snd 1 intend to remain in FORT
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PIERCE, SAINT lUClE COUNTY, FLORIDA, permanently. ~
- ~ . GEORG L. GxISWOI.D
~ (Name)
:;<<:-'.: .
~ '~;~1~~+~+~r~+~~~r~~'. 136 Liberty 1~8y ~ Ft. Piel'Qe ~ Fla.
~ `~~C 'f~~/
~Q-..
Jv
A»•..~OG~~~ (Address)
, 33450
- s~~ ~~:~i~
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~'.Sop ~ ~bsuibed before me this 9th da of aovember , 19 70 .
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GC
~~~''f,,., ~ ~IIR COURT Notsry Public
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By D.C. My ~ommission expires
Ro b~ ~x~wt~d in duplicab •nd ori~inal Al~d whh CINIc G?cuN Cour1, and dupliuh with Tax Aa~.)
, ~ doo~ 188 P~~~ 299
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