HomeMy WebLinkAbout2576 W~luation o/ Domlalf• a~d CftisMahip
TO THE STATE ANO COUNTY TAX ASSESSOR,
Sl. LUCIE C~l1NTY, FlOR10A:
This i: my d~claration of Oomicils •nd Citis~nihip in th~ Stats of Flarid~ that ! am filinq thit day in aaord~na and
in conformity with Chapter ~2?, S~ction 22~.17, Florid~ Ststutes.
~ ws: formsr~y a ~e~e~ resid.~r of Yo{,~ateide ~iew JerseY
. (City) (St~h)
snd 1 residsd at ~ 2 M98tOVe2' COLiY't . Howwar 1 have chan~sd my domidle
~ (Sirest and Number)
ro end am a~d have been a bo~a fids ~esident of the State of Florida :inos 2rid day of
e1~Q»At , 19~?Il, and 1 reside at 204 011ve Ave. 8ive~c Park
(Straet snd Number)
FORT MERCE, SAlNT LUCii COUNTY, RORIDA
and this statement is b be taken aa my decla~ation of dtizanship, attual le~al re:idenc~ and domkile in ths Staro of Horida.
(Insert he~e any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of horr~e, etc.)
E$tablishing residence aad applying for homeatead
20391`~
~UClE COUNTI?~~~
~ CLERR
CIRCUlTRAS -
RECORD bER~F~EO
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I RJRTHER ~HtTiFY that I will oomply witfi all other requirar~nri of a lpal rosidsnt of tfiis Sta».
I FURTNER CERTIFY that I have no intention to return to my former domicjle, and I intend to ramain in FORT
PIERCE, SA~': WCt~ CO~JNTY, FLORlDA, permanently. '
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~:;!e t E~ ~~<<c'` ~ 28th January 1971 .
~w~ to and wbscnbsd b~fore me th s day of
ROGER rOtTRAs
C~CWT COURT Notary Publk
8y `'G D.~. My Gommission txpi~s
tT~ w~icswNr M d~pNc~a1~ ~nd aioinal liled wbb C{Mk Ck~aiif Cw~f, aed dYpIiWN whl~ T~c A~,?
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