HomeMy WebLinkAbout1903 . ,
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10 THE STA1E AND COUNTY Tl1X ASSCSSUk, _
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51. lUC1E COUNIY, FIORIDA: ' ,C
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lhis is my declaration of Domicile a~d Citizenship in the State of Florida that 1 am filing this day in accordance and
in conformity with Chaptcr 222, Section 222.1~7, Florida Statutes.
I was formerly a leyal resident of / P.4NA. 1~ 3 3'>
. (C~ty) (State)
and 1 resided at _.~'TL~1Q~d~Te ~1,f~C.~-T~'4 . However 1 have changed my domiCile
• (Street and Numbe~) •
to and am and have been a bona fide resident of the State of Florida since 3 day of
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_ , 19__, and 1 ~eside ~at
(Str and Numbe~)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this sfatement is to be taken as my declaration of citizenship, actual legal residence and domicile irt 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.)
Applying~ for Homestead f ~ . - •
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- Entering children in school 1 S r ~PiCC ~
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I e a re iden fhis State. ~
I FURTHER CERTIFY that I will comp y with all other requ~rements of a 1 g I s t of ~
I FURTNER CERTIFY that 1 have no intention to return to my former domicile, and 1 intend to remain in FORT ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ ~
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u+ p~n~~nd• s~bscribed before me this ~ day of , 19,~~
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~''btBR~''~IRCUIT COURT Nolary Public
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(3y _ - _ D.C. My Commission expires
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(To bo uxoculod in duplicale and ori~inal ~i1eJ with Cle?k Gircuit Courf, and duplicato wilh Tax Assossor.) ;
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