HomeMy WebLinkAbout1334 Declaration ot Domicilf a~d Citlze~ship
TO THE STATE AND COUNTY TAX ASSESSOR,
s1. ~uciE couNnr, FLORIDA: `
This is my decia~ation of Domicile and Citizenship in ths State of Florida that I am filiny this dey in aoo~rdanos and
i~ co~fo~miy with Chapter 222, Section 222.17, florida Statutes.
1 was fo~merly a legal resident of ~lwaukee W].SCOn31n
(City) ~ (Stebj
and 1 resided at _ 629 MadisO~ AVt. , Hcv„ever 1 have chanqed my domiCite
(Street and Number)
b a~d am and have been a bo~a fide resident of the Stab of Florids since MaiCh 1 day of
~ , t9 68, and ~ roside at 3101 Morningside Blvd
(Street and Number)
FORT ~IEItCE, SAINt LUCIE COUNTY, fLORIDA
and this statement is to be taken as my declaration of citi=enship, actual legal re~sidenoe and domiale in fhs State of Florida.
~ (Insert here any pe~tinent facts, such as sale cf propery or business, or ~elinquishment of employment
at former domicile, removal of family to new domicile, purchase cF home, etc.)
homestead purposes
f ILEO ANO RECAR~FI.A'.
ST~RECORD VEa~EO
i'7411'7
~69 JAN 24 A~ ~0:2~3 .
G~,c/
0 . ~Of7R~,S
R ~RCUI? GOUaY
~~ER
~
i
I FURTHER CHtTIFY lhat 1 wil! oomply with a!I other rsquirement~ of a leyal resider~t of this State.
I FURTHER CERTIFY tF~at 1 F~ave no intention to retum to my former domiale, and I in to remain in fORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
?
~ ~ ame) ime r M. Joha son
. ~f•
. r
f e.. s3 reSS) i
' Swor~.t~ind wbxribed before me this 24 day Jan~ary ~9 69
~ •
t1 • .
. ~ ~OOt~ ?OI~~J?S
4~RK C~CWT COURT Notary Public E
BY O.C. My Gor+r~nission expins
a. b. .~~.a M d„pli~.~. .~a ..i~iwal t~ wN~ a..k u.wM c.~.~, .~a a~k.r. wi~ T.x ~?~......a
~~175 ~~331
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