HomeMy WebLinkAbout0845 . - _ ~ _ . , . . - . . .
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. Declaratio~ ot Don~icile and Citiz~nsAip
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~ TO THE STATE AND C~UNTY TAX ASSESS~R, ~
137'8~4 `
51. LUCIE COUNTY, Fl~RiOA: ~
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~ This is my deciaration of Domicile and Citixanship i~ the State of Florida that i am fifing this day in atcordante and 4
~ in confo~mtty with Chapter 222, Section 222.17, flo~ida Statutes. '
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; . I was formerly a legal resident of ~.___HJC~t~l?i~__._.~-_--_.____.___ _ ~rvland _
(Ciy) (Stah)
; and 1 resided at ___4410 Og1et_hOrDt ~t~, However I have:.hsnged my'domicjle
(Street and Number)
~ na fide resident of the State of Florida since tlgth day of '
{ b and a~n and have bee~ a bo
~ ~'~Cb__.__._ 19_..._.~4 and I reside at whiat~eri-nq CrCe1C Vi11~gc..
, ~ ~ (Street and Number)
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~ I~ORt MERCE, SAINY WCIE COUNTY, FLORIDA
_ ond th~s staiement is to be taken as my daclaration of citizenship, actual legal residence and domicile in the State of Florida. '
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(Insert here any pertine~t fads, such as sale of property or business, or relinquishment of employment
at former domicile, remova! af family to new domicile, purchase of home, etc.)
~ Bstablishing rts:idency for thevaelves and lhier son Kenneth C.Jr
~ (Mha is ia the hospital )
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1~'.-~,C.~.''t'~ ' . r~t~ , MD RECQRQEO
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-~~;.,s..'. . . y~ RO G E R P
r • • • U! i'RAS Cl~~RK
. ~;,~`,,'`•;...Y ST'. LUCIE COUNTY,
•;`'j~l~~~: FI~RlOA
t 1 FURI'HER CERTIFY that I will comply witfi all other requiremenis of a lega) resident of tfiia State.
t
~ I FURtHER CERYIFY that I have no intention to return to my former domi~il~, and I intend to remain in FORT
~ PIERCE. SAINT LUCIE COUNTY, FIORIDA, permanently.
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. ~~;~ti~rttr~:;i;i; ~
: ~ ~~`"t~ J (Name)
1Cenneth C SMartz i
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i~ r`~E~i~~/,~• . -
: ,,,r : w ~ C ~ (Addr s)
; - ~ ~ ~ - Gtntvieve ~Martz ~
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~ 9tb August '
_ , r i~ j'~ ~ubscribed before me this _ day of _ , 19~_.
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R~~ ~ _ ~
~ CIRCUIT COURT Notary Public ~
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gy ~-G D.C. My Commission expires
~ Ro be ~~wcvt~ ~a duplisN~ and ori~inal ~il~d with ClKk Cirwit Cot?~f, and duplicsh with Tax A~sr.)
OR~e~ ~
ROOK.IiG~ zt~