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Declaration ot Domicile and Citizenship ~
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TO THE STATE AND COUNTY TAX ASSESSOR, `
Sl. IUCIE COUNTY, FLORIDA:
This is my dcclarotion of Domicile and Citi=enship in the State of Florida that 1 am filing this day in accordance and
~n conformity with Chapter 222, Section 222.17, Flo~ida Statutes.
I was fo~merly a legal ~esident of ~~~s*~ ~Ot01]to _ Qn~3~~ -
~C;ty~ (State)
36 Preston Road
and 1 resided at However I have changed my domic.i~e
(Sireet and Number)
to and am and have bee~ a bona fide resident of the State of Florida since ~tb-- day of
November , 19 67 and I reside at 6805 So I.~d.River I~rivs+ _ {
(Street and Number)
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FORT PIERCE, SAINT LUCIE COUNTY, RORIDA ~
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Flo~ida. ,
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
fistablishing residence and,applying for homestead
FILEO AND RECOROED
ST. IUCs~ CCU~JTY, FLA.
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16566'7.
'S8 i'i:R 2 s AM i!: 4 s
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CL= Rh C~ZCUIT COURT
1 FURTHER G'ERTIFY that I will aomply with all other requirementa of a le~al resident of this State. ~
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I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remain in FORT '
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. '
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: n Jos Woebr '
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~ ' - Anna Marie Woehr
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"',r ~ '••...:..•••~ry
~'~'`~Q~~,~~~~subscribed before me this 29th day of March , ~q 6$
ROGER POITRAS
CIRCUIT C RT Notary Public
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D.C. My Commission expires
(To bs ~x~cut~d in duplicab and ori~insl fil~d whfi qKk Cireuif Court, and duplicst~ with Tax Ass~s~or.)
aooK 171 PAGE 433
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