HomeMy WebLinkAbout2964 De~larutdon ot Domicite as:~: Ci~tizcn;.~~:~
i O THE ~TATE AfvO COUNTY TAX ASSES~OR, 218514
Si. LUCIE COUNTY, r'IORIDA:
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Tn;s ~s my declaration of ~omiciie and Citizensh~p in thc State of Florida that 1 am fil~ng this day in a:corcance and
~n conformity with Chapter 222, Section 222.17, Florida Statutes. -
i was formeily a legal resident of _~O~COW- _ Pe~ -
tCiry) (State)
and 1 res~ded at - _ - - - However I have changed my domi~ile
(Street and NumSe~)
~o and am and have been a bona fide resident of the State of Florida s~nce _?th day of
_ OCt. 19___??and I reside at?19 CitY'ti~ AVe.
(Street and fVumbe:) ~ :
FOR7 PIERCE, SAINT LUCIE COUN?Y, fIORIDA
; and this ssatement is to be taken as m~r declaration of citizenship, actua{ fegal resiCence and do:niciie in the State of Fiorida.
- (tnsert here any pert~nent facts, such as sale of property or business, or rel•,r.quisz~~ens of employment
s at fo~mer domiciia, removal of fami{y to new domicile, purchase of home, etc_)
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° Eatablishing reaidence
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I FURTHt"R CERTIFY inat ! will comply with all other reruirernents of a legai residan; of !his Stase.
~ I FURTHER C~RTiFY thas I have no intention to returr~ to 'my former domic,ile, and I insend to remain in FORT
P;ERCE, SAIN7 WGE COUNTY, FIORIDA, permanently.
. - a
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- - . . • • (Name)
. Wil,~ard Ftable._
. ,
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- _t . . - - -
` . . (A9~(95Jd
:'::i~~ . Ann Frable
_
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= Swocjt:f~'6pd iubscr+bed before me this _ ~ day of - T , 19~~. t
_ _
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: R~G"cR ~017RA5 -
C:.ERK CIRCUtT COURT (`osary P~olic ~
_ ~ / - ~
oy ~ ` , . ' D.C. My Comm~ssion exp;res - - - ;I
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- (To bo oxocuted i~ duplicate ind or'~ginal filed with Clork Circuit Court, and duplicate with 7ax Assussor.)
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