HomeMy WebLinkAbout0984 Deciaration ot Domicile and Citizen~hip _
TO TNE STATE AND COUNTY TAX ASSESSOR, ~^nO~Q ,
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51. LUCIE COUNTY, FLORIOA:
This is my declaralion of Domicile and Citizenship in the Sta~e of Florida tl~at I am fil~ng this day in accordance and
in conformity with Chapter 222. Section 222.17, Florida Statutes. ~ #
- ~~~1 /J~ F
1 was formerly a legal resident of _-`~!~~!r~L~r - Y / _
~ (City) (State)
a,d 1 resided at ~~~sr '~~wti ~~^'e Howeve~ 1 have changed my domi~ile
(St~eet and Number) ~
to and am and have been a bona fide resident of the State Qf Florida since ~~f day of
- , 19~~, and 1 reside ~at _~d1~'R 7 ~"'C ti5 Y'°~' r'-
' (Street and Number) ~.o.r~ w..~~ P-d~'k
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this siatement is to be taken as my declaration of citizenship, actual lega) residence and domicile in the State of Florida.
(insert here any pertinent facts, such as sale of property or bus~~ess, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Applying j for Homestead
- Entering children in school : ~p,~ e ~ ~ ~ 1 ~ro~^-• s
. ~a ~u+o ~
. - sT uc~F co~~ ~
Roc~r ~o~rnns ~
c~x~ c~RCwr cou~ ril ~
, RECORO YEF.;r1ED-~.~~~f~
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Oct 11 I s3 PN'72 ~
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24U018 -
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1 FURTHER CERTIFY that I will comply with all othe~ requirements of a lega) resident of this State.
1 FURTHER CERTIFY Ihat I have no intention to refurn to my former domiG,ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
L' //T i~ .f .C. ~ s
o fJ i .~i~-~l ~
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(Name) t
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~ . f., ~F~A2 /So~? o? 199 J.s+M~l ~2~. LAkcwc.~d ~-~syC~
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~ ; J • ~ , ' .-fi: (Address) .
c~G~±;~ - ;
• er . ' ~ w.' .7 ~ O' 'J~~ ~ ~ . ~ 9_L~~ i
. $ .fii"to af~~subsuibed before me this day of ~ ~ ~ , ,
+ ; • ~A`~~ r : . ~
. 1, ~ ~ x - ~
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~~~o~~R`" Ppt ~RdS ' . ~
~ '~•,~tf~RKC~R~~17 COURT Notary Public ~ ~
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By D.C. My Commission expires
,
(To be oxecuted in duplicate snd original filed with Clerk Circuit Couvt, and duplicatu witb Tax Assessor.) ~
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ao~~ ~O7 PAGE 98~ ~ `
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