HomeMy WebLinkAbout1141 Oecla~ation ot Domicile a~d Citisenshlp
TO THE STATE AND COUNTY TAX ASSESSUR,
Sl. WCIE COUNTY, FLORIOA:
1
This ~s my declaration o{ ~om~cile end Citizensh~p in the Stete of Floride that 1 am f~l~~g this day ~n accordance and
~n conformiry w~th Chapte~ ??2, Sect~on ?2?.17, Floride Statutes.
I wes forme?ly a legal resident o~ucasville Ohio
(City) (Stete)
and I resided at Rt 3 BOx 290 Nowtver 1 have thanged my domicjle
(Street end Number)
ro end am and have been a bona fide resident of the State of Florida since 28th . dey af
Septsmber , t9_?0 , a~d 1 reside at Rt 4 BOZ_ 26~--__-_---- -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDi?
and this statement is to be taken as my declaration of citizenship, ectuat legal residence and domicilc ~n the Stete of Floride.
(Insert here a~y pertinent facts, such as sale of property or business, or relinquishment of employme~t
at former domicile~ removal of family to new domicile, purchase of home, etc.)
Establishing residence ~ ~ • -
FIl.EO AND RECOROEO!
ST. LUCtE COUNTY. FLA.
~F CORn v~ R!~'~E~
199i00
-
'TO SEP 30 AN II: 00
iIOGER POITRAS
' CLERK CIRCUIT COURT#
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1 FURTHER CERTIFY that I will comply with all other requi~ements of a legat resident of this Stste.
~ 1 FURTHER CERTIFY that 1 have no intention to ~eturn to my former domiule, and I intend to remain in FORT
PIERCE, SAINT IUCIE COUNTY, FIORIDf~, permane~tly.
~~~~ar; ' z
~ ~ ~ ~ ,
,~~+t tt: .~t:
# ~ ` ~ }
~ ;;~'-'~e~..~'_.. . (Name)
~ . • Carroll E Weichman
';~~~r'~?; . ± ~ :
~ ~ t ' . ; - - -
.;;~~~~;~x',,:: ~ (Address)
~~!'`t
' ~ y~~ .
~ ••,;r !;"~w~'fa'tQ..rind subxribed before me this 30th day of S_@Q_t@mbel'__ ~ ~q 70
yM~,~~~. ~ , ~ , •
;Y
Roc~ rom~?s _ -
CIRCUIT OURT Notary Public
B ~~E'-~- D.C. ~~A Commission ex irc3s
Y - Y P s
Ro b~ ~x~cvNd in duplical~ and ori~i~al fll~d with C{Klc Cinuh Cour~, and dupliut~ with Tax Ass~swr.)
„ gooK 187 P~f 1141
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