HomeMy WebLinkAbout1922 . C?~:cl~:r~+tiu~~ ~f Dot.~i~il~ ~ic~d Citize~stijp
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10 11iE STATE AND COUNIY T/~X l~~S~S.~OR,
Sl . IUCIE COUNI Y, FLORIDA: i
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iliis is my decla~ation of Oomicile and Citizenship in the State of Florida that 1 am liling this day in actordance and `
in contormity with Chapter 222, Section 222.17, Florida Statules.
I was formerl a le al resident of ~ ~ -
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and I resided at ~ However I have changed my domi~ile
- (Street and Number)
to and am a~d have been a bona fide resident of the State of Florida since ~3-Z~ ~ - day of
_ ' N , 191s~, and 1 reside ~at . ~ °2
(Street a Number)
FORT PIERCE, SAINT LUCIE COUNTY, fLORIDA
and this statement is to be taken as my declaration of citizenship, attual legal residente and domicile in the State of Horida.
(Insert here any pertinent facts. such as sale of property or business, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.) -
Applyingj for Homestead ~
- Entering children in school :
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1 FURTHER CERTIFY that 1 will comply with all other requiremenis of a legal resident of fhis State. '
I FURTHER CERTIFY that I have no intention to return to my former domiule, end 1 intend to remain in FORT
PIERCE, SAINT iUCIE COUNTY, FLORIDA, permanently. ~
; ' - (Name) ~
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.,~~i~1;d•'~~~scr~bed before e this day of . , 19~~!'
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ROGER POtTRAS -
-•CLERK CIRCUIT COURT Notary Public
.
t3y D.C. My Commission expires
(To bo oxocutcd in duplicato and original filod wilh Clotk Circuit Court, an~d Ruplicate with T~x Assessor.) . ,
- ~ooK212 P~1~'2
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