HomeMy WebLinkAbout2556 Declaration ot Domicile and Citisenship 1650`73
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declaration of Domiciie a~d Citizenship in the State of Florida that 1 am filing this day in acmrdance and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
I was formerly a legal resident of ____~gg~ ______~eW Jersey _
(~;~y) (State)
and I resided at _Rt_ 1__ _BOX 4O8 However 1 have changed my domicjle
(Street and Number) - ~
to and am and have been a bona fide ~esident of the State of Florida since ___~th _ day of
- -~OYembe,~ . 19~~, and 1 reside at Q~4 West nd atreet Whi~~i C3 to
(Street a~d Number)
FORT PIERCE, SAINT IUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domi~ile in the State of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
FILEO AND RECOROED ~
Establishing residence ST. ~U~~` ~~Uh'TY. FLA. '
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'68 MAR II 10: 31 j
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~'(,:.•f~'r, ~•~J:1R~g ~
~ CL~RK CIRCUIT COURT (
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I FURTHER CERTIFY that I will tomply with all other requirements of a legal resident of this State. ;
I FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT
. ;
PIERCE~, SAINT LUCIE COUNTY, FIORIDA, permanently. ;
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' . ( me)
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: = - W. rvey Will am~
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~ • . G'~
~ ' . Erma 1iPilliams
~ llth llarch , ~q 68 .
~ Sworn to and subscribed before me this day of
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~ ROGER POITRAS
~ Ct~ERK CIRCU COURT Natary Public
~ ~ ;
D.C. My Commission expires
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~ (To b~ ~z~cuhd io duplicat~ snd oripinal fled with Clerk C~rwit Cou~t, snd duplicat~ with Tax As~swr.) ~
~ 600K PAG~ _
~ ° R ~?0 ~544
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