HomeMy WebLinkAbout1391 Declaration ot Domicile and Citizenship
TO THE STATE A~~D COUNTY TAX ASSESSOR, -I
7
51. IUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenshi~+ in the State of Florida that I am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes.
Willim ton Delaware
I was formerly a legal resident of _ -
(City) (State)
and 1~esided at _ _ DuPOnt H1 ghWa}I _ _ However I have changed my domiCi~e
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since 1St_ day of
November , 19 65 , and 1 reside at _1906 Totten Road
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
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 facts, such as sale of property or business, or relinquishment of employment
at fo~mer domicile, removal of family to new domicile, purchase of home, etc.)
~E HOMESrEAD
FILEO AND RECOROED
IN._ ' ' ~~_800K
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=•~i ' ~ 'bS MAR 22 PM I :23
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; _ . ' f~06cn ~ ~ ~;;.;5. CLERK ~
` ~ - • ~ ~ ST. LUCtE COUNTY,
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~ . _ _ _ . FLORIOA
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~ 1 FURTHER CERTIFY that I will comply with all ofher requiremenis of a(egal resident of this State.
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1 FURTHER CERTIFY that I have no intention to return to my former domiCile,_ a d 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~ ~ /~~-~ij
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(Name) Rudolph ~laesen
,`.,L'.; r..~~CrA~;- John Kiaesen
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i1~.., 1906 Totten Road, Ft. Pierce= Fla.
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d'subscribed before me this _ 22nd day of _ Marcb , ~q~_.
1 A? ~ ~i',;•' .
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~ ROGER POtTRAS
~ CLERK CIRCUIT OURT Notary Public
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~ By D.C. My Commission expires ~
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~ (To be executed in duplicate and original filed with Clerk Circuit Court, snd duplicats with Tax Assessor.) i
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