HomeMy WebLinkAbout1517 Deciaration ot Domicile a~d Citizenship
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TO THE STATE AND COtlNTY TAX ASSESSOR, 2N~~91 ~
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Sl. IUCIE COUNTY, FIORIDA: ~
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This is my declaration of Domicile and Citi=enship in the State of Florida that I am filing this day in accordance and
~n conformity w~th Chapter 222, Section 2~?.17, Florida Statutes.
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I was formerly a legal resident of _ pOLi~hkBepsie___ ____l~@A YOY'~C ~
(City) (State) ~
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and I resided at _ Ke~i11 _He3ght_a _ However 1 have changed my domiule
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since ~ st _ day of
Kg~ _ 19-_7~, and I reside at SO._8th St.
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(Street and Number)
PORT PIERCE, SAINT LUCIE COUNTY, FLORIDA j
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Ho~eatead E~cenption
FILEO aN0 RECOROED
ST. ~UCiE COUMTY ftA.
ROCER PQITRAS
REC~ t? YEk iE0 C~~.Gsrt~ '
' ~I 12 44 PM'1Z
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~ 1 FURTHER CERTIFY that I will comply wifh all other requirements of a legal resident of this 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
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. -
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~ ~ - ~ (Name)
• . ~ ~ ; EdNard 8. Sullivan
- . 1903 So. 8th St.
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''s Sworn~ to and subscribed before me this 4th day of Jznuary ~ , 19 72
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ROGER POITitAS ~
_ CIRCUIT COURT Notary Pubiic ~
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By D.C. My Commission expires ~
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(To bs sxecuted in duplicate snd oripinal ~iled with CIKk Grcuit Court, and duplicat~ with Tax Ass~ssorJ
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