HomeMy WebLinkAbout0825 ~ecla~atton ot Don~icil• ahd Citis~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA:
Th~s is my decla~ation of Domicile and ~iti:enship in the Stste of Florids thet I sm filin~ thi: day in aooc~dance and
~n conformity with Chapter 222, Settion 222.17, Florida Statutes.
Alashin ton New Jersey
1 was formerly a legal resident of
(Ciy) (Stats)
and 1 resided at _----28 BZ'08d St. _ ~wever 1 havechan~ed my domiGle
(Street and Number)
to and em and have been a bona fide resident of the State of Florida since 27th _ day of
_ December , 19 ?0, and I ~eside at 350 Goforth Blvd.
~ (St~eet and Number)
FORT PIERCE, SAINT lUC1E COUNTY, RORfDA
and this stateme~t is to be taken as my declaraticn of citize~ship, sctual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of property or business, or relinquiahme~t of employment
at former domicile, removal of family to new domicile,, purchase of homa, etc.)
(Homestead Exemption)
2v2s~~
iT~ll~lClE COUNTY~fIA. j
ROCER POIMAf ~
- CIERK CIRCUIT COt111T
RECORO VERIFtEO
~11 ~ ~ 48 P~'~ ~
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; I FURTHER tHtTIFY that 1 will comply with all other requirements of a laflal resident of this State. ~
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~ 1 FURTHER CERTIFY that I have no intention to return to my former domicjle, and I intend to remain in FORT
` PIERCE, SAINT LUCIE COi1NTY, FLORIOA, permanently. Ed~/lII Keesler
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(Address)
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` Sworn to and subxribed before me this 4 th day of J anuary 1971 's
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[ ROGiR ~iT~S'y';',~
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~ ,G~, Notary Public
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~ BY ~ _ , , D.C. My ~ommission expires
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~ ao ~ , " .r~!Q.~. .~a ~~.a ~ a.~ u~ c~.~, ~nd duplic~/~ with Tax ~.......a
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