HomeMy WebLinkAbout0654 Oealaration of Domicii~ a~d Cftis~nship1
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TO THE STATE AND tOUNTY TAX ASSESSOR,
51. LtJC1E COUNTY, FLORIOA:
Thi: ii my decla~ation of Domicile and Citiunship in ths Staro of Florida that 1 am filin~ this day in aooorda~ and
in conformity with Chapter 222, Settion 222.17, Florida Statutes.
~ w,: tormsr~y a ~e~a~ rosidsnt of Osf o r d Pen n.
' (Ci~y) (Sta»)
and 1 resid~d ~t R. D. 2 . HowtvK I Mw chsiqsd my domidk
(Stre~t and Number)
ro and am Md have been a bona fide roiident of the State of Florida sinae Dec. 1 dsy of
C/o General Delivery
, 19 68 a~ ~ South Indian River Drive
(Street and Number)
!'ORT lIERC~, S~WT LUC~ COUNTY, RORI~A
and this statarn~t is b be taken as my declaration of atizenship, actual le~ai ~esidenoe and domkile in fhe State of Horida.
pnaert here any pertinant fads, such as sale of property or busi~ess, or mlinquishment of emplo~yment
at formar domicile, re~rioval of family b new domiale, purchase of home, eUc.)
8ntering a~[ children in public school
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FILEO AND R C Y~, A.
ST. lUC1E COU~~'~O ~
~ 1~~~~
'69 dAN ~ ~ ~2`~
~ ~p~E POITRAS
CLERK CiRCU17 COURT;
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1 FURTHER CERTiFY that 1 wiil aomply with ali othK nquiromsnts of a le~aal rosident of thu Stat~.
1 RJRTHER CERTIFY that i hsve no intention to return to my formes domiGle, and 1 intend to remain in FORT
RlERGl; ~SAII~lT, UKIE COUNTY, fLORIDA, permanently.
.
. .
- . -y t~~) Pat icia Wiley
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• ~ - . (Addres:)
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Swo~rn ~o and wbscribsd before ms this ~ day of 19~
RO~t ~OITRAi
C~K CKpNT OOtIRT Notsry Pubik
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9~, D.C. My c«nmissia, .xpi~
a• M•••a»r i~ .~i.i~.~ a.~ ,rilb a.rlc cirwr c~t. .~i ~lio.~. arill~ Tax A....M.a
~175 ~ 65~
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