HomeMy WebLinkAbout1478 ~cla~ation ot Ooeni~ll~ and Citl:~nship
TO THE STATE AN~ ~OUNTY TAX ASSES54R,
Sl. IUGIE COUNTY, FlOR1~A:
This is my decla~ation of Oomicile and Citiz~nship in the 5t~te of Florida thet 1 sm fili~ thi: day in ~ooordance and
in conformity with Chapter 222, Section 222.17, Floride Ststutes.
I was formerly e legs) resident of ~eNtOri C@A~@2' 16888• _
(City) (Staro)
and 1 resided at _~55 JSCk80II St2'eet ~~,,,ever 1 havechanyed my domidle
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since l8t day of
January ?0 1321 SanSevina Terrace
, 19 and 1 ~eside at
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
~(Insen he~e any pertinent facfs, such as ssle of property or busineu, or relinquiahment of employment
at former domicile, removal of family to new domicilc, purchase of home, etc.)
Establishing residence and applying for homestead
2Q3333
ST~~UCIE COUNTY ~LA. '
- ROOER POITRAS
OIERK CIRCUIT COU11t
- IlECOAO VER~FIED~.~---~
J~ 1~1 3 2s PM'T
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I FURTHER CE~tTIFY that 1 wil) carnply with all other~ requirsments of a(ayal residsnt of this State.
I FURTHER CERTIFY that I have no intention to return to my forme~ domitile, and I intend to remain in fORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
. _ ~ ~'Ia~~ ~ J~~d~a.~
~ . ~ ~ ldatoiraa~~ Westermark
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~ ~;~xn to and subscribed before me this 14th ~y of dBAUaY`y ~9 71
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~ ~oc~R romtws
~ CLERK CIRCU COtIRT Notary Public
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~ By ~ D.C. My ~ommission expires ~
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~ Ro b~ ~x~aN~d iw d~licN~ and o~i~inal NI«! wilb CIKk qraiif Ceur1, aed duplisaN wifh Tax As~e~.)
~ ~~189 P~~E1475
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