HomeMy WebLinkAbout1382 Declaratio~ ot Domicile and Citizenship ~
TO THE STATE AND COUNTY TAX ASSES.~OR, 1642,8"7
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in attordance and
in conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
WASHINGTON D.C.
1 was formerly a I~zgal resident of _ _ _ _ _ _ _ _ - - -
~C~ty~ (State)
2939 Vaa Ness St. N.W.ApT•~120
and I resided at However I have changed my domiGile
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since -25th - day of
December _ ~q6?__, and 1 reside ar _ 158 _Lucero Dr.
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FIORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence a~d domicile in ihe State of Florida.
(Insert here any pertinent facts, such as sale of properTy or business, or relinquishment of employment
at former domicile, removal of family to ~ew domicile, purchase of home, etc.)
FILING FOR HOMESTBAD PURPOSBS
FILED ANO RECOROED~
ST. LUCIE COUNTY. FLA.`?
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16428'7
'68 FE6 12 PM !2: 10
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RO~E:F? ~•O;TR;.S
CLERK CIRCUIT COURT
I FURTHER ~ERTIFY that I will comply with all other requirements of a lega) resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
• /
(Name)
MICHABL WALEN
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' (Address)
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~<~wori~.tobn{~_subscribed before me this 12th day of Pebruary ~ 19 68 .
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•~-EI~AK'CIR U COURT Notary Public
gy , D.C_ My Commission expires
(To bs executed in duplicsts and originsl filed with Cler~k Grcuit Courf, and dupliuh with Tax Assessor.)
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