HomeMy WebLinkAbout2714 ~eclaration ot Domlciie and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~~A c
YV
51. LUCIE COUNTY, FIORIDA:
This ~s my declaration of Domicile and Citizenship in tha State of Florida that 1 am fiting this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of . . _ 1~t. , ProspeCt _ _ _ _ _ _Illinoi s _
(City) (State) :
and I resided at 206 No. Ilille Street 1io"veve~ t have changed my domicjle
(Street and Number)
~o and am and have been a bona fide resident of the State of Florida since JBal~ary 7_ - day of
19_3~. , and I reside a~ 113_Beach_ Avenue - River Park___ t
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(Insert here any pertinent fads, such as saie of property or business, or relinquishment of employment !
at former domicile, removal of family to new domicile, purchase of home, etc.) ~
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Establishing residency for hamestead ezemption
~~~E~ ~ECe~~f!
ST.LUCiE :~u~tr f1i
, iiOCE~, r'~tITRAS
CIERK Cli.LU1T COtIIIT C ~
P,FC;~RD vE1 ~F~EO~
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19 10 AN'~1
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° 222~346
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. '
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1 FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
~ RIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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k' - G_~ % (Na ) Alired 0 t -]~2 QrQ ~
°r . . .fl. F
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= . ' .Q ~ (Address) ~
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; " ~Si1vb~l~o`bnd
s~ub+xribed before me this ~ day of ~ ~ _ ~M_
~ ~ . 19 /
- .>,~,~r~,~.~ /~irKLv"
.
=~j ROGER POITRAS
- CLERK CIRCUIT COURT Notary Public
gy D.C_ My Commission expires
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(To b~ ex~cuted ie duplicats and ori~inal fil~d with CIKk Grwit Courf, snd dupliut~ with Tax Ass~s~o?.)
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