HomeMy WebLinkAbout0783 Dec~aration of Domicile and Citizenship _
TO THE ST E AND COUNTY TAX ASS6SSOR, ~
~ ~ COUNTY, FLORIDA: ~~~r~~
'iliis is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in
accordance, and in conformity with Section 222.17, Florida Statutes. _
1 was formerly a legal resident of C~fomia P e n n. and I
(Citr1 ~ (Staee) ~
resided at 4 t h S t r e e t . However, I have changed my domicile to
csaee~ ana Numee.)
and am and have been a bona fide resident of the State of Florida since day of
july ~ 52 Orange Avenue Extension
, 19--, and 1 reside at .
R t. 1 B o x 9 2 7 - F t P i e r c e, F 1 a. csa~~ .pa N~me~~
S t. L u c i e County, Florida,
,
(c~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(lasert here any pertinent facts, such as sak ot property or Ausiness, or relin9uitdment of employment at totmer
domic7e. remoral of tsmilr to aew domicUe, purcdase of home, ete.)
This not only establishes my domicile, but also that
of my daughter, ELIZABETH ANN UHL.
`~o , ~
~
. ~ ~ .
CI.ERK C1RC p+~~
REC01?a YER1F1~
~tit i~ 2`~ ~
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
Ft. Pierce St. Lucie County,
,
Florida, permanently. (c'rr~
~ J o{4 .
~~l
Mrs . William ~U~i~
~ (waaress)
Sworn to and subscribed before me this 11 day of
A p r 11 7 2
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Notary Public Stste Elorida at Larae : ~i,'` *r~ .
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My Commission expires Q--= . ~':zr. .
2 n,a .s,. .
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(To be executed in dupiicate and orisinal filed witA C1ei~G'~~~ witk Ta~[ Apeuor)
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