HomeMy WebLinkAbout0751 Deciaration ot Domicite and Citizensi~ip
TO TNE STATE AN~ COUNTY TAX ASSESSOR, .
51. IUCIE COUNTY, FIORIDA: ~ ~~~~3
This is my declaration of Uomicile and Citizenship in the State of Florida that 1 am fiting this day in accordante and
in coniormity with Chapter 222, Section 222.17, Florida Statutes. , j
~
1 was formerly a legal resident of _~~Q~T YERNON OHIO -
~ (City) ~(State)
/206
and I resided at SO_.__Center Stx'eet However 1 have changed my domiti~e
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since ~ st _ day of
~ October , t9?? , and I reside ~at 1610 OranRe A~enuQ
' (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA '
!h~s statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida.
(Insert here any pertinent f~cts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) '
Applying, for Homestead
S
Entering children in school : CONNIE GREEN Age 12
' f~EO AND RECa~0E0 -
_ . LUCIE COUMTY f~A.
ROCf R POITRAS ~
CLERK CIFCUIT COURT
RECORD YERI~~EO
j ~ ' Oat ~3 3 os PM'71
i ~
2398$3
1 FURTHER CERTIFY that I will comply with al) other requiremenfs of a legal resident of this State.
1 FURTHER CERTtFY that 1 have no intention to return to my former domi~ile, and I intend to remain in FORT
P!ERCE, SAii~t~ l.UCIE COUNTY, FLORIDA, permanentty. GEORGE D. GR~EN
~
Name) -
~ ~~~~'`~`r,~J~lT'~~~'~~~~., 1610 Orange A~e. ~ . ~
~ ~C~ ~.M~~~y~ C ~'t Pierce Foa. -
~ ` ~ J!/ •.~.Q " ~j
S~ ~ ~t . V ~
: i ' ~ • ~ ~ ~ (Address)
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'~SJ or~t ~d subscribed before me this 13th day of OCtObBr 19~_.
.
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.
'„i~~%y .
N~~H~~ ~ .
l~~~~~ ~R ~~'O I T R A S
UIT COURT Notary Public , ~
~ •
By D.C. My Commission expires
(To be oxecuted in duplicale and oric~inal filed with Clerk Ci~cuit Court, and duplicate with Tax Assoswr.)
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