HomeMy WebLinkAbout1000 Declaratio~ at Domicits and Citizenship ;~13~49
TO THE SiATE AND COUNTY tAX ASSESSOR,
Sl. LUCIE COUNTY, FlOR1DA:
This ~s my declaration of Dom~ule and Citizens!~ip in the State of Florida that : am filing this day in accordance and
;n conformity with Chapter 2??, Section 22~.17, Florida Statutes
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I was formerly a legat ~esident of -
~C;ty~ (State)
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and 1 resided at Sn~~~ ~ 3~~- Nowever I have changed my dorniGi~e
~ (Street and Number)
fo and am and have been a bona fide ~esident of the State of Florida since ~~~`1`'"~ ~O - _ day of
7~ re id as ~ '~!~,Ir~'~ - Lc.C'/ND~/f ~i
. , 19._ , and I s e ~
(Street and i~lumber)
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FORT PIERCE, SAINT IUCIE COiiA1fiY, ftORIDA
and th~s statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~
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(Insert here any pertinent facts, such as sate of property or business, or relinquishment of employment
at former domicile, remova! of family to new domicile, purchase of home, etc.)
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213049 ~
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FILEO AMD RECORDEO
ST. ~UCIE COUMTY FCA.
ROCER POITRAS '
CIERK CIRCUIt COURT X~ _
RECORD VERIFIEO t
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I FURTHER CERTIFY that I will comply with all other requir~ments of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiule, and I intend to remain in FORT 1
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~ PiERCE, SAINT LUCIE COUNTY, FIORIDA, permanently.
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(Name) Frede~Cick W. Wolf ~
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~ .~p/L?~3' f~ ~ - /~_/yE~?tif o.~~ ~ R~ ~r -
s' (A~'dress) -
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~ Sworn to and subscribed before me this ~
~ _ . _ day of _ _ _ . _ _ _ 191~ -
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~ ROGER; ~a1T:tA~k-'~'••;~~ ~
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~ 'CIRCWT ~ = --Notary Public -
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gy U.C_ My Commission expires
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(To be exscutw~ in ~+plicate and ariginal fifed with Cl~rlc Grcuit Court, snd duplicate with Tax Ass~ssor.)
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