HomeMy WebLinkAbout0767 . ~
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aclaratlo~ ~ Do~Ici1~ and CitisMShtp
TO TNE StATE ANO ~OUNTY TAX ASSESSOR, ~
Sl. tUC1E COUNTY, FlOR1~A.
Th~s ~s my declaration of Oomitile ~nd Cit~z~r~sh~p i~ tht St~te of Florida that 1 am fil~nq this day aaoord~ ~nd
~n conformity with Chapte~ 222, Settion 2?2.17, Florida Statut~s.
~ was fo~me~ly a ieyai .e:~de~t of __South _ Salem _ _ _ _ _ _ ~iex York____
(City1 (Siat~~
and 1 resided at _ Rt.- ~l' _ . Howeve? 1 hav~ thar~~d my domiGile
(St~eef and Number)
to snd am and have been a bona fide resident of the Sta1t of florida since ~____.?Oth _
_Jul.~?- 19?~ , and I~sfde ar 355 Yfdw~y? Rd.
(Street a~d Numbar)
FORT MERCE. SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, attusl le~al residet~ca and dornicile in the State of Horid~.
(Insert hera any perti~ent facts, such as sale of property or business, or ~eli~quishma~+t of e~nployn?ant
at former domicile, removal of family to new domicile, purchase of hane, etc.)
Residenc$
2G2835
FaEO ~~+o ~coR~
:T, ~OCtE C01lMTY ~
110CEp P01TIlA=
CIEaR CIRGtlIT
RECORO YEi~iF1E0
~1 il x? I~'11
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~ 1 FURTHER C'HtTIFY that I wil! aomply with all other requirarr~snts of a le~aal rosedem of this StaN.
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I FURTHER CERTIFY that 1 have no intention ro return to my formN domic~le, and 1 int~d to re~nai~ ;n fORT
~ PtERCE, SAINT LUtIE COUNTY, FLORIDA, permanently. ~~~(~-L-..~--~
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~ YILLEDGT J . WII.LZlJ1S
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s:ti?~tt,j,.,
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~ ,,,..,..,,~~'p''•, 355 Yidway Rd., Ft. Pierce, Fia.
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; (Acldress) 33450
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' ~ 4 th Y J anua ry 71
~ ,S~ypnt,b~.ui~ sut~3tribed before me this da of , 19 - .
~ .,.`-13,i t-
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~ Q~K CIRCUR COURT Notary Publ+c
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~ By ~.C. My Commiuion expires
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Re b~ ~c~evl~d in dupKu~ and efi~inal fii~d wilh CIMic Ciea~if Cw:t, awd d~t'ieaM ~ Tavc w~rJ
~ 765
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