HomeMy WebLinkAbout2299 Decta~ation ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, ~~SS
Sl. lUC1E COUNTY, FIORIDA:
Th~s ~s my declaration of Dom~cile and Citizenship i~ the State of Florida that 1 am filing this day in accordance and
~n conform~ty w~th Chapter ?.22. Sect~on 222.17, Florida Statutes.
Fredonia Wiaconain
I was formerly a legal resident of -
(City) (State)
and I resided at _ Rt_l _ However I have changed my domicile
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since _ 16th _ day of
I~orember 19
71 , and 1 reside at _ 402 NO. 39th street
(Street and Number)
'rc3it7 PIERCE, SAIN7 LUCIE COUNTY, fIORiDA
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of properry or business, or ~eli~quishment of employment
at former domicile, removal of family to new domicile, purchase of home, ett.)
Eatablisr.ing reaidence
~T~iuc
E couM~Y ~i,°~.
~ IIOCEk POITRI~f L
: QLERK CiRCUIT COURT
~ . RlCORp YER?iIED
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~ 1 FURTNER CERTIFY that I will comply with all othe~ requirements of a legal resident of this State.
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- I FURtHER CERTIFY that i have no intention to return to my former domiqle, and I intend to remain in FOR7
~ PIERCE, SAINT=LUCIE COUNTY, FLORIDA, permane~tly.
- -ti;. /~7 _j' .
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' ~ . ~~'~~~%~t%C- 1
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. (Name)
~ ~ . Oliver H. I,ied
~
. . „ ~oess)
_ E~angeline Lied
- Sworn to and subscribed before me this ?th day of December ~ ~q~,
ROGER POITRAS
CL~RK ClRCUIT COURT Notary Public
/ /lJ
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- By _ D.C. My Commission exp;res
(To be executed in duplicate and original filed with Clerk Grcuit Courl, and duplicate with Tax Assessor.) ~
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a~~97 ~
. _ ~-'96