HomeMy WebLinkAbout1583 Deciaration of Domicile and Citizenship
TO THE ~TATE AND COUNTY TAX ASSESSOR, 2`~1~~~ ~
51. LUCIE COUNTY, FLORIDA: ~
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This ~s my dec~arat~on of Do~icite and Gt~zenship in the State of Flor~da that 1 am hling this day in accordance and
:n conformity with Chapter 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of 1dan11uE _ _ _ NeM!__ Y0I'k
(C;ty} (State)
and I resided at 4~24 ~r821-Delphi R08C1 However I have changed my domicjle ~
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(Street and Number)
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to and am and have been a bona fide resident of the State of Florida since ~ ~th _ day of
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October ,~9_ 71, and I reside at _ 6705 So. Ind~en_River Drive .
(Street and Number)
FORT PIERCE, SAtNt LUCIE COUNTY, FLORIDA
and this statement ~s 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.)
Nonestead Exeaption
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~ I FURTHER CERTIFY that I will comply with at) other requirements of a legaf resident of this State.
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~5 I FURTHER CERTIFY that I have no intention to retum to my former domi~ile, and I intend to remain in FORT
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~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_
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~V•~ ~l~G ; - - (Name) -
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-z 5.~.3 a;~ : Harry I. Steele
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Sworn't4,and1subscribed before me this day of -___s~aTlt~aZ~?_ , 19_~_.
= = ROGER POITRAS -
~ C K CIRCUIT COURT Notary Public
- gy - D.C. My Commission expires
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- (To be executed in duplicate and original fiied with tlerk Circuit Court, snd duplicate with Tax Assessor.)
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