HomeMy WebLinkAbout1691 , Declaration ot Domicile and Citiz~nship
TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCiE COUNTY, FLORIDA:
This is my declaration of Oomicile, and Citize~ship in the State of Florida that 1 am filing this dsy in acoo~danos and
~;,:,formity with Chapte~ 222, Section 222.17, Florida Statutes.
1 was formerly a legal resident of M81t8 New York
(City) (State)
and I resided at - Rd. ~ ~@1Ch DY'. . However I have chs~ged my domiCile
(Street and Number)
b and am and have been a bo~a fide resident of the State of Florida sinoe 2nd day of
Sg~~ember , t9~, and ~ reside at 618 Beach Ave. River Park
(Street and Number)
FORT PIERCE, SAINT LUCIE COIiNTY, FLORIDA
and this stateme~t is to be taken as my declarotion of citizenship, actual lega) residenoe and domicile in the State of Horida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
(Homestead Fsemption)
FIL'EO AND RECORDEDj
ST. LUCIE COUNTY. ~LA.
R~CORQ VER(~tED
18900:
'10 JAN 3 0 AM 9:
~
~
~=~,J:~~? i'OITRKS
CLERK CiRCU1T COURT'
~
1 FURTHER ~ERTIFY that I wil) oomply with all other requirements of a IeQa! re:idsn! of this State.
I FURTHER CERTIFY that I have no intention to retum to my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
Dawn I,achnicht (~ra. Willism)
p,~Q~-~ ~.~~~-~ij~-.'~
(Name)
. ~ ~ ~r;~ 618 Beach Ave . River Fark
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'i? ` (Address)
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•:a... i. LC;'r1~
° Sworri,t~~nji~tubauibed before me this 30th day of Januarq ~ ~q 70 ,
_N:~_. ~
T~4; ~:J ; b :
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`f C ~~~!'1i'dIT~S
' , 'ttRCUR+COURT Notary Publk
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8y D.C. My Commission expires
(To b~ ~xeeut~d in duplicst~ snd ori~inal fil~d with Cl~elc C•ireuh Cour1, and duplieat~ with Tax Ass~ssor.)
BOOK ~O~ °I!GE~6~9
No. 13 ~
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