HomeMy WebLinkAbout1497 _ . ~
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Ds~la~ation ot Domicile and Citisenship '
. 1334~£3
TO THE STATE AND COUNTY TAX ASSESSOR,
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Sl'. lUC1E COUNTY. FlOR10A: ~ ~ ~
This is my dacluation of Domicile and Citise~ship in the State of Florida lhat I am filitq thit day in aoootdano~ and
in aonformily with Chapter 222. Settion 222.17, Florida Statutes. .
1 w~s formerly a le~aal rosid~nt of _~ls to 1 ~ V s.
(Ciry) , (St~b) i -
~nd 1 rosidsd at rOUtc ~ 1 ' . . How~ 1 haw charped my domWl~ ,
(Sf~eet and Number) ' '
to and am ~nd have been • bona fids rosid~nt of the State of Florida sina 2~d d~1/ ~
~ February 19 65 108~ North 16tb
, , and I reside at 2
(Str~et and Numb~r)
l~ORT MERC~, fAiNT LUCIE COUNTY, RORIDA
and this statement is ro bs taken as my decla~ation of citizenship, actual le~l residenos and domidls in fhe Stats of Horida. ~
y pe~tnent facts, such as sale of property or bu~insss, or mlinquishmsnt of emplo~t
(Insert here an ~
st former domicile,.~emoval of family to new domicile, purchase of Fwtr~e, etcJ •
~ntering William 1~. Uwens in tne ~ llth grade
l33(~~8 .
~ f1t.ED AND RECORDED -
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. 196Sf - p 2: 19 ~ ~r:;>- ';'ra _
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ROGEr~ Pp~TRAS. CIERK ~ . ' _ ~
ST. LU61E COUNTY F ::'S I~''r'
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. LORIDA l ;~'~:o/y ~ S f
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F 1 FURTHER CHtTIFY that 1 will oomply with all other raqul~b of a Ipal n~id~nt of thl: Stah. .
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` 1 FURTHER CERTIFY that 1 have no intention to retum to my formsr domWle, and I intend b remain in fORT ~
PIERCE, SAINT LIfCIf~.~OUNTY, FLORiDA, permanently.
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F ` - .1 "'~~r~ Siizabeth owens
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I"~,~'~; .-O .~t (/~ddns,)
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Swor~ ~o and subscrib~d b~fors ms this sth day of PARRIII~tY . 19._bS ~
ROOEt l011'RA: :
COURT . Notary/ Publk !
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dy D.C. ~ My Commissbn ~xpi~u ;
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- R• b..ao.aihr M~pacM..~d «ioi~al ~awa ~NeN. wili~ T.oc A...r..a
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80~;~ 1 I ~(•t :
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