HomeMy WebLinkAbout0109 ~eclaratlo~ ot Domicil• and Citizen~hip
• TO TME STATE AND COUNTY TAX ASSESSOR, '
Sl. IUCtE COUNTY, FIORIDA:
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This is my declaration of Domicile snd Citizenihip in ths Stat~ of Florida that 1~m filin~ thi~ day in aoo~rdana and ~
in conformity with Chapter 222, Ssction 22Z.17, Florida Statutes. ~
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I was fo~me~ly a leflal ~esident of New YOrk ~ New York
` (City) (Stafe)
and 1 resided at ~ q 7 th S t. . Howewr 1 have chanqed my domkile
(Street and Numbet)
ta and am a~d have been a bona fide ~esident of the Stete of Florida sinoe ll t!1 day of
_ Ju y ,~q ?0 , a~ ~ a~ 379 Brookside Terr.
(Sheet and Numbe?)
FORT PIERCE, SA{NT LUCIE COUNTY, RORIDA I
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and this statement is to be taken as my declaration of citizenship, actual legal rasidence and domicile i~ the Stete of. Florida.
(Insert hare any pe~tinent facK, sucF~ a: sale of property or bu:inesx, or relinqui~m~nt of emptoym~nt
at f~ormer domicile, ranoval of family to nsw domicile, purchase of homs, ~tc.)
~ (Homestead Facemption)
`~L02398 " i
f LEO Al10 REC~ROE~
~ ~ WC1E COUN Y flA.
IIOCER P0ITAAS ~ / ,
~ CIERK CIRCUIt CO~RT ;
RECOII~ vEa~FiED i
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~C 22 ro 2s aH~~t/
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1 FURTHER CERTIFY that 1 will aomply with all other requirsm~nb of a le~al resident of this State.
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~ 1 FURTHER ~ERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FOR7
PIERCE, SAINT LUCIE COUNTY, FLORIDA, parmanently. OttO J. ReV
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~ Sworn to and subsu~bed before me this 22nd day of December 19 70 _ ~
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~`~tii::~:.~ttty,~~, ~
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~ U , C~
~CC~?RT Notary Public
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~ By _ ~ ~ ~ ~ D.C. My Commissio~?~ expires
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o'~i' tn ~ d~ptiat• sed orianat fil.d with q..lc ~ cew~, aad drplicaN witb Tax A~wasxa
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- 189 P~~E ~ Io~
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