HomeMy WebLinkAbout0377 Declaratlon ot ~omicil• a~d Citi:e~ship
TO THE STATE ANO COUNTY TAX ASSESSOR,
51. LUCIE COUNTY, FIORIDA:
This is my declaration of Oomicile and Citizenship in the State of Florida that 1 am filiny this day in aooo~dants and
~n conformity with Chapte~ 222, Section 222.17, Flo~ida Statutes. ~
1 was formerly a legai resident of _ I?8wY'@IICe M888. _
(City) (Stats)
and 1 resided at 364 HOwe2'd St. However 1 havechanyed my domitile
(Street and Number)
to and am and have been a bona fide ~esident of the State of Fiorida since 14th day af
July_____ ,~9 70 , a~d I reside at 479 SBridis Dr.
(St~eet and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Inse~t here any pertinent facts, such as sale of property or busineu, or retinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)'
(Homestead ~:~cemption)
2G 25`?' ;
ijlEO AM~ RECOIiOE! ~
i~. LUCtE COUNTY FtA.
ROCER POIt11AS
CLERK CIRCUiT COUNT ~
' RECOAO YERiF1ED~.,.~..~
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I FURTHER ~HtT{FY that 1 will oomply with all other requirements of a le~al residant of this State.
I FURTHER CERTIFY that I have no intention to return to my farmer domicjle, and I intend to remain in FORT
~ PIERCE, SAlNT LUCIE COUNTY, FLORIDA, permanently. W~11~8ID H. Johnson ~
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~ 29th December
~ Sworn to and suburibed before me this day of , 19~Q_.
`~~~N:s:.rut~r~,
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~f• ` ~ ; Notary Public
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~ By ' i D.C. My Commission expires
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.a;!'i~.~,~iuti and orioinal fil~d wi11~ Cl~rk Graeh Cou~f, and dupticat~ wfth Tax As~or.)
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