HomeMy WebLinkAbout2142 D~claratia~+ ot Domicile ant! Citiscenship ~
TO THE STATE AND COUNTY TAX ASS[SSUR,
Sl. LUCIE COUNTY, FIORiDA: i~~'~"'~~~''1~
t
. ,
This is my declaration of Domicile and C:itizenship in the 51ate af hlorida tnai i am iiii~~g inis c~ay in acecs~aaric~ and
in conforinity with Chapter 222, Section 222.17, Florida Statutes.
Pittsfield ~ New tlampshire
I was formerly a legal resident of _ - . - -
. (City) (State)
and I resided at _ Rt 1 However I have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the 5tate of Florida since _.2211d day of
~ December 65 . 1212 Daymon Avee
- - 19---- , and I reside at -
, (5treet and Number)
FORT FIERCE, SAINT LUCIE COUNTY, FLORIDA
and tf~is 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 prop°rty or business, or relinquishment of employment
at former domicile, removal of family to nevv domicile, purchase of home, etc.)
Applying for homestead ~
, , . ~N~~ a E~o pEo
~ ~so
~ ~ _ ~ oK
. : , . ~ ~ •i::;` ,ss F
~ , G~.
- ~ - ~ ~ ` FB ~ y p~ 2 . 3
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: ~ ~ :i,- ~ Ra~ER PD~r
' , . : . ~,~'.'r; LU~~E C~U~ ~E~~C ~
, •4: •~E`:~°~~;- ~L4~~~ T1'•
, .
f 1 FURTHER CERTIFY that I will comply with all other requirements of a legal resiclent of this State.
€
~
~ I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
c
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. <
, / i n ` ,
x V~ ~
. ' ~ /~O lJ ?~J (Name)
-~y . ~ _ ~rs A, Peppin
. f# :l ~ ~ ~ . ~ ` ~ .
; 3 - . - ' •j (Address)
- .
14th Februar 66
~ Swbrn'~o and subscribed before me this day of Y , 19 •
ROGER POITRAS
RK CIRCUIT CO T Notary Public
gy ~k-~-~~ p.C. My Commission expires
(To be executed in duplicate and original filed with Clerk Circuit Court, and duplicate with Tsx Assessor.)
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800K ~.~s 3~s