HomeMy WebLinkAbout2874 ~
Declaratio~ ot Don~Icii• And Cltisenshlp ~ I
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TO THE STATE ANO COUNTY TAX ASSESSOR,
5~. lUC1E COUNTY, FIORIDA: ~
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This is my detlaration of ~omicile and Citizenship in ths State of Florida that 1 am filing this dsy in acaordanoe and
in conformity with Chapter Z?2, Section 222.17, Florida Statutes. .
I was formerly a legal resident of ~untain HOme Nnrtl, r~arnt i Y,~
(~ity) ~ab)
and 1 ~esided at ~9~?'ood Drive (P. O. BOx 186 ) . However 1 have c~arped my domidle
(Stroet and Number) '
ro and am and have been a bona fide reside~t oi the State of Florida since 26th day of
Noveiaber 68 243 Whisnering Creek vii~ac~~
- , 19 , and I reside at
(Stteet snd Number)
FORT PIERCE, SAINt LUCIE COUNTY, RORIDA f
end this statement is to ;a taken as my declaration of citizenship, actva! laga! residenoe and domicile in the.State of Horida. '
(Insert hare 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.) ~~g,
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F1LED aN~ RECOR~FLA
C ~tlTY^~
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69
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CLy~K C1RCU~t
1 RIRTHER G'ERTIFY that 1 will oomply with all other rer{uiremenb of a lepal rasident of thls State. ~
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I FURTHER CERTIFY that 1 have no intention to retum to my former domiCile, and 1 intend to remain in ~ORT
PlERCE, SA1NT LUCIE COUNTY, FLORIDA, permanently~ except for visits to other areas.
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(Name) F~RENCE C. WILLIA,MS
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(Addres:) 243 Whispering Creek
~ ~ _ ~ ~ Village ~
' ~ ' Fort Pierce, Flo da ;
Sworn to and subscribed before me this b~ ~ i~ ~ ~q
.
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ROGER POITRI?S a~ •
tLERK CIAC!!~* COURT = ' , ~ -
~e o v x rX~~b~S,~b~~t. ~tarP ~f Fr•-.-~+~ ai large
0 r My Commission Exqres Dec. 16, 1969
BY D.C. ~.~~WY C~nl~;~r~e~9q~ld b!C Itansamerica Insurance Co. ~
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(To b~ ~x~cubd in dvpllcat~ and ori~nal til~d wili~ Ct~lc , and dupli~a» wi1l~ Tax Aapsor.)
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