HomeMy WebLinkAbout0574 i
Dectarat~on ot Dornictle and Citlsenship f
:~.i"?'83'?'
TO THE STATE AND COUNTY TAX ASSESSOR,
Sj. LUCIE COUNTY, FLORI~A:
This is my declaration of Domicile and Citizenship in the State of Florida that 1 am filinq this day in accordance and
in conformiy with Chapter 222, Section 2Z2.17, Florida Statutes.
wiLisQtoa N. c.
I was formerly a legal resident of
~C~ty~ (State)
, However i have cha~ged my domiti~e
and 1 resided ai
(Street and Numbe~)
to and am and have been a bona fide resident of the State of Florida since day of
Route 3, Box S10
, 19~~, and 1 reside at
(Street and Number)
FORT PIERCE, SA1NT LUCIE COUNTY, FLORIDA .
and this statement is to be taken as my declaration of citi=enship, actual legal residence and domicile in the State of Florida.
(Insert here any periinent facta, such as sala of property or business, or relinquishment of employment
at former domicile, removat of family to new domicile, purchase of home, ett.)
Tbis Dosicile and Citizenship is being filed in order to
eater ay t~o grandchildren in public achool...the parenta
of said childsen ~rili srri~e in tbe near fnture 4nd intend
~ to ~ite tbis their peraanent hoate, The children ares Anthon~
Milea ind Mar~ ~rlene Dliles. FiLED ANO RECORDED
ST. LUCIE COUNTY. FLA.
N'.;_CQP(~ VFRI*=~C
'69 t~~~ 5 ~M 9: 42
.
;
,,~;~r_~ Ot ~ ~:.s
~ CLERK C1R~~IT COURT
i
~
E
~ 1 FURTHER CERTIFY that I will oomply with all other requirements of a legal resident of this State.
E
I FURTHER CERTIfY that I have no intention to return to my fo~mer domicjle, and 1 intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
o~-~
~ ~ntar„e) rq e Bozesan
~ . .
~ -
~ (Address)
~ i,'
_ . • _ .
. ~ - ;
`.Swotn i~ and
sulisuibed before me this day of 19
_i - ~ _ O-
~ -
Pdtttt~ .
. ~i~1~~COURT Notsry Public
gy D.C. My Commission expi~es
Ro b~ executod io dupliat~ and ori~i~ riieci wisb C:.:::c Gra+it Court, aod dupl~cst~ witk Tax AssQSSO~.J
~177 ~ 57~
w.~. - - =
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