HomeMy WebLinkAbout1463 Declaration ot Domicile and Citise~ship 180~~
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. WCIE COUNTY, FLORI~A:
This is my decla~ation of Domicile and Citizenship in the State of Florida that I am filing thi: day in socordante and
in conformity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of -~11/iutee _ Wiaconsin
. (City) (Staro)
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and t resided at a818 So~th 13lh 3lrelt ~~,,,ever 1 have changed my domitjle }
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since day of
Ju~e . 19 69 and I reside at T~porary Holiday inn, Stuart,Fla.
(St~eet and Number)
~ORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale ef property or busineu, or relinquishment of employment
at former domicile, ~emoval of family to new domicile, purchase of home, etc.) ;
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The filing of tbis inatruueat ia to indicate be Mish of
Batablishing residence• Jeroae J. Yooieczny ia inthe Ar~y
and is reporting bacY to Pt. Bragg, and tben on to Vietaao.
Nr. Yonieczny or+n property in St. Lucie Countq and would like
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to call this his reaidence. ST LL~~ E ~ RECORDED'
~:`C~qp OUNTY F _
• ~ RlFtEp ~a.
,69 18p~p~
~ JUN 30 pH 2; p9
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~ CLER~~ Eh `,017R~G~O~L~.l~ ?
~ K CIRCUIT COURT~ i
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` I FURTHER CERTIFY that 1 will oomply with all other requiremenri of a le~al resident of this State. ~
I FURTHER CERTIFY that I have no intention to return to my former domiGte, and I intend to remain in FORT
PIERCE, SAlNT LUCIE COUNTY, FLORIDA, permanently.
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~ . Jero~e J. Iconieczny
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' ' Sworn to and suburibed before me this 30th day of June , ~q69
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~ ROGER ~OITRAS
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~ CIRCUI? COURT Notary Public
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~ By D.C. My Commission expires
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• Qe b~ ac~evbd in dupiieat~ and oe+~inal fil~d wHb Cl~lc preuit Cou~, •nd duplleat~ wilh Tax AtwMer.)
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