HomeMy WebLinkAbout2695 Decla~ation ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR. 16~~2
Sl. WCIE COUNTY, FIORIDA~
This is my declaration ot Domicile and Citize~ship in the State of Florida that 1 am filing this day in accordar~ce and
in conformity with Chapter 222, Sectian 222.17, Florida Statutes_
1 was forme~ly a legal resident of ___F3S~ls~l _ Ohio _
tCiy) (State)
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and I resided at ,1120 _ EBSt S8=1duSky Howevcr 1 have changed my domiti~e
(Street and Number)
to and am and have been a bona fide ~esident of the State of Florida since -_Zth__ - day of
_ Aplll 19 bT, and I ~eside at ?16 Sp~.+h 12th
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA i
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Inse:t here any pertinent fads, such as sale of property or business, or relinquishment of emptoyment
at former domicite, removal of family to new domicile, purchase of home, etc.)
Establish resideacy for homestead purposes
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FILEO AND RECORDE~ '
ST. ~UCIE COUNTY, FLA. ;
Fic COPD 4'FRlFIED ;
163~232
_ '68 J~tN 3 AI~1 I i: 5 9 ov~ ;
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..;+_,F:: .p~-=~:.$ !
~ CLERK CIRCUIT COURT ~
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I FURTHER CERTIFY that I will aomply with all other requirements of a legal resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domiale, and I intend to remain in FORT
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PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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(Name) Y?EO11tt ~=if~f~
Wiseley
(Address)
-~p~" , ' _ :
~ Srrot~i•to and subscribed before me this 3rd day of r January , ~q 68_ ;
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ROQEII 1~SITRAS ~
~ CLERit ~UR COURT Notary Public ~
g~~~" ~ D.C. My Commission expires ~
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(To b~ ~x~cut~d in dupliuh snd ori~inal fil~d witb CIKIc Cim~it Court, and duplicat~ wiTh Ta~c As~ssor.)
- e~K 169 PA~~ 2676
No. 13 • - -