HomeMy WebLinkAbout1375 Decla~atio~ ot Domicile and Citisenship
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FIORIDA:
This is my declatation of Domicile and Citi=enship in the State of Florida that 1 am filing this day in atoordante and
in conformity with Chapter 222, Section 222.17, Ftorida Statutes.
I was formerly a legal resident of L~rnbrook T__`_ New York _
(Ciry) (State)
and 1 resided at _~...~Z_ChestIIllt St. However 1 have changed my domitile
(Sireet and Number) -
to and am and have bee~ a bona fide residerit of the State of Florida si~ce 15 th _ day of
_~~gril__ , 1910 and 1 ~eside at 902 AIItfg118 AV@. ~
- (Street and Number)
EORT PIERCE, SAINT LUCIE COUNTY, RORtDA
and this statement is to be takeri es my declaration of citizenship, actual legal residence and domicile in the State of Ho~ida.
(Insert here any pertinen~ facts, such as sale of property or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead Ezemption)
~ 2,01344
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I FURTHER CERTIFY that 1 will oomply with all other requirements of a legal resident of thia State.
1 FURTHER CERTIFY that 1 have no mtention to.return to my forme? domiG~e, and I intend to remam in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. wi1118ID H. S~f$@8_
. ~
1~ • ~
(Name)
~
- (Address)
Swo~n~?~~ subsuibed before me this 23rd day of NOVeIDber ~ 19 70
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% Nota Public
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By ' • D.C. My Commission expires
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(t'~.~ ~ wN ind ori~inal fil~d with Cl~rlc CkwN Cou~t, and duplicat~ wiH~ Tax Assesso?.)
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