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Decl~rat~an of ~omicii~ ar~d Citizen~hip p ~
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TO THE STATE AND COUNTY TAX ASSESSQR, ~
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Sl. LUC#E C{?~J!~lTY; FIORiL~A: _
t f Florida that I am filin this da in accordance and ~
This is my declaration of Domicile and Cih~enship m the Sta e o 9 Y
in conformity with C~~apter 222, Section 222.17, Florida Statutes ~
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I was formerly a legal resident of _ W8S_~rV~~~Q __~lorida _ ;
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(City) (State) ~
and I resided at _ Gener8l deliVe~r _ . Nowever I have changed my domi~ile
(Street and Number) ~
to and am and have been a bona fide resident of the State of Florida since day of ~
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------ll@G~II1beY' - _ . _ , 19_~3 , and I reside at ~1~1-~__ A~re: -K--
(Street and Number) ~
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FORT PIERGE, Se41NT LUCI~ COUNTY, FLORIDA :
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and this statement is to be talcen as rny declaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(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.)
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Appl,ying for homestead 1
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~ ' ' . FILE~r AN RECORdEO ~
: _ , . . : , ~ • r.. E ~i - ~Ti~CI~~-~~ECDY.~-~ 0 0 K
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'66 JA~~~ 21 A~~1 10.37 ~
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i ~ '.f`'•'r• r ~ -,~?:cJ. CLERK . ~
. ,.',r . ROGE~ f:~~ : =
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sT. ~uc~E cour~TY,
~ ~ F~ORIDA ~
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1 FURTHER CERTIFY that I will comply ~vith afl other requirements of a legal resident of this State. ~
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I FURTHER CERTIFY that I have no intention to reiurn to my former domi~ile, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
, • + ~ . , . ~-~C'l a ~ " - ~ i
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~ . (Name) . _ '
, ~ . Horace E Huggins ~
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. ~ , _ ~ ~ - ~ (Address) €
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~ $wqiri ~tq!~and,subscribed before me this 21 day of _-,LanA112'3r 19- ~
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ROGER PQITRAS
CRK CIRCU~ COURT Notary Public '
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gy D.C. My Commission expire3 r
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(To be executed in duplicate and original filed with Clerk Circuit Court, and ctupliate with Tax Assessor.j ~
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