HomeMy WebLinkAbout1253 Declaration of Domicile and Citizenship
"f0 TNF. STATE: ANU ('OUNT1' Tr1X ASSl:SSOR,
St Luc ie _~•UUNTY, f~ LORIUA: i~+4~'-s
Tl~is is my ~Irclaration ot~ Domirilr and Citizrnship in the Statc a1~ Florida that 1 am tiling this day in
accor~lanrr, and in ~ont~orn~ity with Scction ,,,.17, Florida Statutrs.
~ Tomahawk Wisconsin `
1 was i'orn~~rh~ a Icgal residrnt of ~nd I ~
~ ~c~~r~ ~s~~~e>
rrsi~icd at R t 3 . How~v~r, I havc changed my domicile to ~
- - - .
(Strret anJ Numbr~)
and am and havr b~ rn a bana iide r~sidc nt ol~ the State ot~ Florida since __~1 s t day oC
_NQV~m~er_ i 9 _ Z2 ~ncl i re~idr at _ R t_2 _Box _A_2 Venture Out ~
1Slrett and Number) ^
Ft . Pierce Fla . St . Lucie County, Florida,
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~c~v ~ - - • - -
and ti~is statement is to b~ takeil ~s my declaration of citizenship, :ictual legal residence and domicile in the State
ot~ Floricla.
(lnsrr~ herr anY prrtinrnt facls, wch as sal~ uf pruprrty or businrss, or relinyuishment of employment at fotmet
domicile, remoral uf tam~l~~ to ne~v dumicile, purehase of home, rtc.)
~
Establishing residence 24~16 -
FILEO AhU RECORpfO
ST. lUCtr CqUMTr FLA.
ROC'r r F;,!TRAS
CLERK ~UIT COURT
RFr~- ^ ~.,i tED
1
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No~ 11 1 os PH'11 ~
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~ 1 FURTHE:R CERTIFY that 1 will register at my local address when the registration books reopen, and
~ comply with all other rec~uirements of a Iega) resident of~ this State.
; 1 FURTHER CERTIFY that 1 ha~-c nF~ intention to return io my fom~er domicile, and I intend to remain in
~
; Ft. Pierce __Fla._--- - _ - s_t. Lucie - , County.
' Floric~a, ,Qerman~tty.
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? ~O ? !l • ~ - - (Name) s
- Anne Van Wi 11 igen
11 ~G Q = ? . - - I~ddress)
s . '1 ~
` SAr~orn to•~idZ~Hscribrd beforc me this 21__ _ day~ of S
~ f~no~ . ;
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' - November _ A.D. 19_ ~
; a. ~l~~_ ~c?~t~-t~--~- - - - ~
iVotary Pubtic Slale f Florida at Largc ~
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~ My Commission expires _ _ _ _ _ -
s ~ ~
~ (To be r~ecuted in dupticatr and urigin.~l filyd ~vith Cletk (`ircuit Court, aoJ duplicate with Tax Asxrssor)
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