HomeMy WebLinkAbout0866 De~larali~n of Dc~rniCile and Citia~enshi~
P
TO THE STATE AND COUNTY TAX ASS~SSOR, ~~t'~f.~
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of Ok~E'CIlOL~ee__ , j,pr-ifja_.__ "
(City) (State)
and I resided at _ ~3 ~ Avenue ~ . Nowever 1 have changed my domi~ile ;
(Street and Number)
to and am and have been a bona fide resident of the State ot Florida since _7 _ day of
blarch b5 160? Flori.da Avenue
_ - . 19-- - , and I reside at - - - - - - -
(Street and Number)
FORT PIERCE, SAINT IUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Ftorida. t
(Insert here any pertinent facts, such as sa~e of property or business, or relinquishment of employment
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at former domicile, removal of family to new domicile, purchase of home, etc.) j
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Establishin , residence ~ r. ; " • ~•;t
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1 FURTHER CER7IFY that I will comply with all other requirements af a(egal resident of fhiS~State:~: `
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. : : - . ~
! FURTNER CERTIFY that I have no intention to return to my iormer domiCile, and I intend,fo remain in FORT ~
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PIERCE, SAINT LUCtE COUNTY, FLORIDA, permanently. .
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. - . - ,~%.t-P~a `
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' (Name) ~
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. . - Rebecca Willis ~
j . f~: ~s (Address} ~
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~ SwcStr~,ta ~nd subscribed before me this 17 day of ,Ianuary )q 66 ~
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€ RO~GER POiTRQS ~
~ CLERK C UIT COURT ` Notary Public
By ° D.C. My Commission expires
~ (To be axecufed in duplicate and origina! filed with Clerk Circuit Court, and duplicate with Tsx Assessor.) -
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~ BGtR1K ~J~ ~
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