HomeMy WebLinkAbout1745 aalw~atfon ot Domlail• a~d CitisMShtp
TO THE STATE AN~ COUNTY TAX ASSESSOR. + 2C 3499
si . ~uciE couNnr, FLORIDA: .
This is my declaration of Domicile and Citiz~nihip in th~ St~te of Ftorid~ that 1 am filinq this day in acoord~nce and
in co~formity with Chapter 2~2, Section 222.17, Floride Statutes.
1 was formerly a legal ~~ident of - RoChe ster N• Y•
(City) (Stste)
and 1 resided at ___12 SheZ'woOd AYe.,i Webster~ N. Y. ~Weverl havechan~sd my domkJle
(St~eet and Number)
to and arri and have been a bona fide ~esident of the State of Florida sinoe July 22 day of
_ , t9 and ~ reiide at 132 Solida Drive Port St Lucie
(Shest snd Number)
fORT MERCE, SAINT WCIE COUNTY, RO~IDA
and this statement is to be taken as my declaratwn of citizenship, actual lagal residence and domicile in tfie Stste of Florida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purthase of home, etc.)
homestead
~uEO a~~ ~E~
Sf ItlCIF CMNITY f~
CLER`C ~CiNT~f~IMT ~ 0
RECORO YERtF1E0~....~
J~ 19 i ia tM'T1
. 2G3499
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~ , I RIRTHER ~HtTIFY thst 1 will oomply with all other ~squirements of a le~al nsident of thi: State.
~ I FURTHER CERTIFY thst 1 have no intention t~n return to my former domirjle, and 1 intend to remain in FOitT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ Horace J.
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~ ~ " (Address)
~ - . ~.~J : ~i...~F` .
~ : = • 1 J anuarY ? 1
~ ~p "sybsaibed before me this 9 day af , 19 .
~ 'i~ •••i~,~.r G .
~ - :7 •~jwi ' ~ C .
: " -
~ ; t~ Notary Public
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~ 8y r O.C. My Commission expires
(Te b~ ~x~cuhd in dvpticat~ and oriainal fil~d wilb C{~k prarit Cov~l, and duplial~ witb Tax As~or.)
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# , ~ ~oK 289 P~~f 1740
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