HomeMy WebLinkAbout0100 . . r ~ ? . . . .
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' ~ Oeclaratton ot Do~nicll• a~d Cittse~ship -
~ TO THE STATE AND COUNTY TAX ASSESSOR, 1~~~ ,~4
ST. WCIE COUNTY, FIORIDA:
This is my decluation of Domicile ar?d Citisenship in th~ St~t~ of Flaida that 1 am filinp this day in ~ooo?dana ~nd ~
ie~ aonformiry with ~hapter 222, Ssctbn 22?.17. Fbrida Stahrta~. j
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~ wa: tormsrly • 1e~s1 msidMt of 1"~lwaukee . wisconsia ~
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' 8428 K'est Lisbo~ A~e ~
~nd 1~kied at • Hcvwve?1 ha ch+npsd my domWl~
~ (StreN ~nd Numba)
b and wn a~d haw bae~ • bona fFds resiclNnt of th~ Stat~ of Ftorida si~os 16 th
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October ~q 6S „ 181 Whiaperin~ Creek Village
- (Stn~t ~nd N )
n~c~, , ao~~ G~~~,~„~'`
. roRT snarT tuc~E touNnr ~ D~ 3 /~K ' '
and this st~tarwnt is to be taken as my dedantion of dtiYenship, actual Ipal ~esidsncs and d8mk11~ in th~ Stat~ of Hortd~.
: (Inssrt here any pertinsnt facts, such as sale of property or bu:lnss;, or relinquishnisnt of ~mploymu~t
~t formsr domicile, removal of family to new domidle, purdwss of hort~e, etc.~
New Dom~cile - ~ •
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~ ~ f~.EO AND RECORDEO .
IN ' 800K ~ o~ 3~~''~,,,, -
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1965 JtINN -6 AM I I: 5S = ~ , ~ '
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. R06ER POtTRAS. CIERK . ~t ~ ;~o~-,~.~~ _ ~`i ~
- ~ $T. LUCIE C8f1NTY~. FIDRIQA .:,r~,?~~ ~ ~
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~ I FUR1'HER CHtTIFY that i wlll cornply with dl aAher nquinm~nts o# a Ipal r~id~nt of thb St~t~. •
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- 1 FURTHER CERTIFY that 1 have ~o intenNon to rotum to my former domk)Is, a~d 1 Intend to rem~?fn in fORT
_ MERC'~ ~S~ ~ ~..UJCIE,COUNTY, ~ORIDA, permanently. `
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~ - "i~,~„~.'..,~~ . : Mrs. Gladys 1?R WisoSChniCk .
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Swor~ ~o and wb:cribed b.for~ m. thl~ bth day of JanuarT , 19~..
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~ , ROGiR NOITR/ls ~
~ ClERK ClRCUIT COI~ Notsry Publk
~ ~ • O.C. - My CannJuio~ ~xptra
tT~ M ar~e~N~d M drpNcal~ a~wi ~ai Al~d C1~Ic CirswM Cwef,~ ~pNta~N wilb Taoc A~~~
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