HomeMy WebLinkAbout1185 Deciarat~on o! ~br~icil~ an~d Cittzenshi{p ~
TO 7HE STATE AND COUNTY TAX AS5ESSOR, ~
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Sl. LUCIE COUNTY, FIORIDA:
Tt~is is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in atcordance ~nd
in conformity ~vith Chapter 222, Section 222.17, Florida Sta~utes.
I was formerly a legal residei~t of JaCkaOri~f~.le F'1.OT'S.dA
- - - ~(:ity) - - - ~ (State)
and I resided at _____211a3_ _Gilmer 5t _ However I hav~ changed my domiCile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since day of
212 St.Lucie Ave,
`~~X - _ , 19-65._, and I reside at -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUN7Y, FLORIDA
and this statement is to be ta4sn as m; c~?claration ~f c~tizenship, actual legal residence and dorr,icile in the State of Florida.
(Insert here any pertinent facts, such as sale of property or b~~siness, or relinquishment of employment
at former domicile, removal of family to new domici!e, purchase of home, etc.)
Abnlyi~i~ for homestead
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• ~T. ~.UC1E ~"w'~'• i;L'c`RY
~ FLOR pQ~~lTY.
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident o~,this State. .
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~ I FURTHER CERTIFY that I have no inteniion to return to rny former domi~ile, and I iri?end.'t,d rem~in in~~-0RT
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PIERCE, SAINT LUGE COUNTY, FLORIDA, permanently. .
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~ - ~ " _ Albert E Ho~res
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Swom to and subscribed before me this 2j~ day of dA~An*~ , 19-fif1.
ROGER POITRAS
RK CIRCUIT COLiRT Notary Public
g ~ D.C. My Commission expires -
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~ (To be executed in duplicate and originai filed with Cierk Circuif Court, and duplicate with Tax Asse;sor.)
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