HomeMy WebLinkAbout0820 D~cla~atio~ of Domicil~ a~d Citiz~nship
TO THE STATE AND COUiVTY TAX ASSESSOR, ~
Sl. lUC1E COUNTY, FLORIDA:
This is my declaration of Oomicile aRd Citizenship in the State of Flo~ida that I am filing this day in acoordance and
~n conformity with Chapter ?22, Section 222.17, Florida Statutes.
I was formerly a legat resident of H8x'tf Otd COIIri. _
(City) (State)
and 1 resided at 65_websteY` St. ~~„~ever I have chan~ed my domi~ile
(St~eet and Number) '
to and am and have been a bona fide resident of the Stste of Florids since _ 20th day of
~8y-- , 19 ?0, and I reside at 3709 Ave. 0
- (Street and Numbe?)
FORT PIERCE, SAINT LUCIE COUNTY, fLORIDA
and this statement is to be taken as my declarotion of citizenship, actual legal reside~ce and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, w relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, ett.)
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(Homestead Exemption)
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F1Lf0 AMD RECQR~E~
ST.lUC1E COUMTT ~ .
ROCER IOITNA3
CIfRK CIRCUIT COWtT
RECORO QERIPlEO ~
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~ I FURTHER CERTIFY that I will comply with all other ~equirements of a le~a) resident of thia State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
~ PIERCE, SAINT IUCIE COUNTY, FIORIDA, permanently. MBTle C. Graycer
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,t Sworn to and subscribed before me this 4th day of January ~ ~q71
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~ G • C~COURT Notary Public
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~y - ~.C. My Commission expires
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~ ~~1t i~ dupiiuN snd ori~inal fil~d wifb CI~Ac GrwN Cou~f, and duplicat~ wili~ Tax A~waor.)
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