HomeMy WebLinkAbout0811 ~~claratlon ot Domiail~ and CitiseMShip
TO THE STATE AND COUNTY TAX ASSESSOR,
51. IUCIE COUNTY, FtOR10A:
This is my declaration of Oomicile anc! Citizenship in the State of Florida that I am filinfl this dsy in aceordance a~?d
confo~mity with Chapter 222, Section 222.17, Florida Statutes_
I was torme~ly a legal resident of _Se~~c ago _ I11 _
(City) (State)
and I resided at 5828 DT01^th P8u11ri8 St7ceet _ _~wever I have changsd my domic,ile
(St~aet and Number)
ro and am and have been a bona fide resident of the State of Florida since lst dey of
-.~~g~~-- . 19
~Q, and I res'ide at 2972 S. E. Sants An1t8
(Sheet snd Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLOitIDA ~
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 o~ business, or refinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.) ~
Establishing residence and applying for homeatead
2~2856
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F ~ED AMD RE I
i~. `uCiE Cou ~E~,
IIOCER /01 A1 ~ ~
OLERR CIRCu1 0{M
RECORO YERIFIEO~,.~,.,,~
. J~ ~ I oZ PM'71 ~
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~ I RIRTHER CERTIFY that I wil) comply with al) other requirements of a leyal resident of this Stab.
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~ I FURTHER CERTIFY that 1 have no intention to return to my former domicjle, and 1 intend to remain in FORT
~ PIERCE, S/~NT LUCIE COUNTY, FLORIDA, permanently. ~
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~ ~t- Alice . Jensen
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~ Swom to and suburibed before me this th day of T~_~~ , 19~_1
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h ROGER POITRAS
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~ CIRCUIT COURT Notary Public
~ 0
~ 8 a~~~'~' D.C. My Commission expires
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~ " Ro b~ ~x~cut~d In dupliuh and oripinal fll~d whl~ d~lc Cira~it Co~rt, snd dupliut~ wi/h Tax As~or.)
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