HomeMy WebLinkAbout0910 i
Oeclaratlon ot Domicile a~d Citizenship
TO THE STATE AND ~OUNTY TAX ASSESSOR, .L
Si. LUCIE COUNTY, FLORIDA:
This is my declaratio~ of Oomicile and Citizenship in the State of Florida that I am filing this day in aaordanae a~d
in aonformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a le~al resident of Zockridge Iowa
(CiA~) tState)
P. 0. Boz ~Q~ 104
and 1 resided at . Howevsr 1 have changed my domic3le
(St~eat and Number) r
ro and am and hsve been a bona fide resident of the State of Florida since October ~ day of
, 19~$, and 1 reside at ROIItB 2. BOZ 3100
(Street and Number)
FORT M~CE, S/11NT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaratio~ of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent fads, such as sale of prope?ty or business, or relinquishment of employment
at former domicile, remova) of family to new domicile, purchase of home, etc.)
homeatead purposes ~
F1lED ,41Vp RFCORO
sT, IUC~~ COUN~'Y ED'
RF.~CORp yER1F~FplA.
'69 ~aH ~~3~
AM s~
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I RJRTHER GERTIFY that I will aomply with all other requirements of a leyal resident of this State.
I FURTHER ~ERTIFY that I have no intention to retum to my former domiale, and 1 intend to remain in fORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
.1'
• ~ •
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iJ•e~• • ~.tr " ~ - ~ John L Wilder
' cr _ (Name) •
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' yt,~ r. :
~ '~j~r3r . . J - .
~ ' (Address)
C~''. ~
~ 14th January . 69
SworNt~ and subscribed before me this day of - , 19 . ~
aoa~e ro~?s . .
CLERK CiRCUR COURT Notary Public
By D.C. My ~ommission expires
(To b~ ~x~aM~d in dvplieaM aed ori~inal fil~d wifh G~eic Cirwff Couif, and dvplieafr with Tax A~sior.)
B~K 175 ~E ~OS
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