HomeMy WebLinkAbout0719 ' ~
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i
~ecl~ration of Doe~iaile and Citia~nstti~a ~ ~
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TO THE STATE ANU COUNIY TAX ASSESSOR, i
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
I was formerly a leyal resident of _ _ . ~11~1C?tl_.__ _ _,_.-.-Qh10 ~
(City) (State) ~
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Rt 1 PrOSpeCt However I have chan ed m domiCile ;
and I resided at ~ 9 Y ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __~t h_ - day of
_.Tune 65 427 Cocoanut R_iver Park
19----, and I reside at
(Street and Number)
FORT PIERCE, SAIN? LUCIE COUNYY, FLORIDA '
and this statement is to be taken as my declaration of citizenship, actual fegal residence and domicile in ihe State of Florida.
(Insert here any per~inent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family tc~ new domicile, purchase of home, etc.)
PILED AND RECORDEp
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~ Applying for homestead , Q
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- ~ L'UCIE CUU~VTYRK
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I FURTHER CERTIFY that I will compl with all other requirements of a legal resident of this State. ~
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FURTHER CERTIFY that 1 have no intention to .return to my former domi~ile, and ( intend to remain in FORT ~
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I' PIER.C~"'SAtI`NT'r1,~1CIE C~UNTY, FLORIDA, permanently. ~
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Y ,h. ~ ,a - - (Name) -
~ " ~ _ - r : ; John J Gordon
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~ Swom to and subscribed before me this 12th day of - Januarv , 19~b_.
; ROGER POITRAS
RK CIRCUIT fOURT Notary Public
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By cz"~`~ ~a D.C. My Commission expires
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(To be executed in duplicate and origina) filed with Clerk Circuit Court, and duplicate with Tax Assessor.) ~
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