HomeMy WebLinkAbout1077 ~eclaration at D~orrri~ile and ~itizen~t~ip
TO THE STATE AND COUNTY TAX ASSESSOR, t C, o
t ~ ~7
S~. LUCIE COUNTY, FIORIDA:
This is my declaration of vomicile and Citizenship in the State of Florida thal I am filing this day in accordance a~d
in conformity with Chapter 222, Seclion 222.17, Florida Statuies.
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I was formerly a legal resident of SILVER CREEK NE~V 1'ORK ;
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~~ity) ~S~~tal
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207 Cen t r a 1 Ave . Nowever I have cFian ed m domi~ile :
and I resided at - - - - 9 Y
(Street and Number)
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to and am and have been a bona fide resident of the Siate of Flarida since lSt-- day of
~ei- , i9_6?., and I reside ar __309_DVorth 21st street _
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(Street and Number)
FQRT PIERGE, SAIN? LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, rernoval of family to nev~ domicile, purchase of home, etc.)
Applying for homestead
D RECQRDED
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- ~ ~ ~~r '66 JAN 2 0 PM ~4 : I 3
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t::<,; 1; -
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~ ~ . ~ ' ~ ?r ROG~.f~ f~l/i i ~`1~7. CI.ERK !
~ 'n ~ ' LUCIE COUNTY
~ • - ~ r:.% ST. ~
"s. . ' FLC3'RIDA
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State.
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' '~.;;'J .~t~RTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
i " .
' PIERC~, SAI~lT' kUC1E COUNTY, FLORIGA, permanently_
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_ . `c~~ ' - yF .(Name)
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" John N Smith
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' • . - - •i;:.. _ • i
' rt'~ ' ~ . l~k••~'`3 (Address) ~
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F.-
20th January , ~q 56 ~
Sworn to and subscribed before me this - day of - -
:
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j ROGER POITRAS '
' ERK CIRCUIT COURT Notary Publit
g ~.•~~'-L'~~ D.C. My Commission expires
(To be executed in duplicate and original filed with Clerk Circuit Court, and duplitate with Tax Assessor.)
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