HomeMy WebLinkAbout1086 :
~
t
Declaration ot Domicile and Citizenship ;
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. LUCIE COUNTY, FLORIDA: ~
This ~s my declaration of Domicile and Citizenship in the State of Florida that f am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal ~esident of _ . _Dubl_ln - - - -P~~• -
(C;ty) (State) ~
~
and 1 resided at ~~_gh Street #28 _ _ _ _ . However I have changed my domiule
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since September 15th _ day of
19
Tl_, and I reside at Rt_ 2 Ae= 5048 _
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, fIORIDA - ~ -
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.)
~
Filing for homeateed ezemption
~E~l1r TiF~E~
iT.t,~Cti LQ~i?#ITT fLA,
' RO~CF FpiTR1~S
~ ~E"~ ::'Cb1~ COUNT ,
` ItfCr~•; •;F~ :1~~~
{
f ~
E F~ ~ 10 56 {U! '~Z ~
~
}
F
4
~ 223~2
~
i
~
~
~
~
~
~
A
~ 1 FURTHER CERTIFY that I will comply with all other requiremenfs of a leya) resident of this State.
~
~ I FURTHER CERTIFY that I have no intention to return to my former domiCu~e, and I intend to remain in FORT
~ ~IERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. J
~ , . . ~ 7 ~
~ ' : (Name)
~ - Edward F. 1(i 11
" ~ ~
~ ~ -
(Address)
• s
••~vir~'Jo.ahd suburibed before me this ~ day of , 19,z1~
- . ~
~ ~
ROGER POITRAS -
_ CIERK CIRCUIT COURT Notary Public ~
- x
~
j:7 8y ~ D.C. My Commission expires
.
~
(To b~ ~xxut~d in duplluts and oripinal filed with C{Klc Circuit Court, and duplicat~ with Tax Ass~ssor.)
0^R r/~r ~
t~;i No. i3 ~Y~~;~~ (~UI
_ ~ _ _ _ _ ;