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HomeMy WebLinkAbout0190 - - -----,~~~-.f ~ ~~claration ~t t9omi~ile ar~d Citizen~hi~ TC~ THE STATE AND COUNTY TAX ASSESSOR, i Lq S'~~~~~ t 51. LUCIE COUNTY, FIORiDA: r~_ .L_ 1 1:1"' ~L.:~ .-1~ ~r~~ Ih15 IS lllY C]EC13~a1iOfl dT UdiillLiiE' aiiU l.iTiZ8f1S(li~~ ifl Tile Jii3ic Ui i iUitUa st~oi t u~T~ c~~c:~y i~~~~ :.s~ ii, VS`.~VfVVi1{.L ~,~u ~ in conformity with Ci~apter 222, Section 222.17, Florida Statufes. Buf falo _ New York I was formerly a legal resident of . . _ _ . _ _ _ _ . . _ . (City) (State) - 439 ~e S t F e r r}? . Ho~vever 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 _ lSt day of ~ October _ ~q_ _b$ and I reside ai __18_18 _ ~inney Dr ~ (Street and Number) ~ ~ FORT PIERCE, SQINT LUCIE COUNTY, FLORIDA ~ `i 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 fads, such as sale of property or business, or relinquishment of employment ? at former domiciie, rernovaf of family to new domicile, purchase of home, e~c.) ~ . ~ ~ ~pplying for homestead ~ •:~~~17:.: ~ . . 1 . _ .1 : ' • . v v ~ z '.;,:-f';~, FIL~ *AN~ RECORDED ; . ~ . - a ~ _ ~N ~~~~~~.6r..,..-- BOOK _ . , ` , ~ ~ _,-!7~,~-'Cc' G L ~ t_ ~ { ~ I~ - ~ ~ " : - - . ; ' <<' : 966 JAN 2 8 PM 12 : ( ~ ~ . v ` ~ ~ ~ ' - i ~4 ~~)~1;..f~.,, - i~ ~ ~6,~t1 / ~ ~ a ~ ~ , ROGER PJ~ i R,'~S, CLERK ~ ~ " ST. LUCIE COUNTY, ~ FLORiDA ~ ~ ~ ~ 3 ~ ~A • il ~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. ~ ~ I FURTHER CERTIFY that I have no intention to re!urn to my former domi~ile, and I intend to remain in FORT ~ . ~ PIERCE, SAINT lUCIE COUNTY, FLORIDA, permanently. ~ . - ; . ~L~• . • ' . ' /j -~l~I C~c~f/~ ~ _ ~ - ~ , ~ ~ , ~ (Name) _ ~ ' ~ . Frank j-.tlndrews ~ . - . , ~ . - _ - ~ ' , ~ - ~ (Address) s 3 f i Swom to and subscribed before me this 2$ day of --_-~-aAaiuv , 19~1(1-. ~ ~ ROGER POITRAS ~ ERK CiRCUii ~URT Natary Public ~ # g ~ D.C. My Commission expires ~ Y ~ ~ ~ (To be executed in duplicate and original filsd with Clsrk Circuit Court, and duplicate with Tax Assessor.) ~ . i ~o~K~~~ ~so - ~ ~