HomeMy WebLinkAbout0098 Oeclaratio~ ot Domicile and Citizenshi;o ~
TO THE STATE AND COUNTY TAX ASSESSOR. 14~399
Sl. IUCIE COUNTY, FIORiDA:
This is my decla~ation of Oomicile and Citizenship in the State of Florida that I am filing thi"s day in aaordanae and
in cor~formity with Chapter 224, Section 222.17, Florida Statutes.
Montesum~ Georgia
1 was forme~ly a legal resident of -
(City) (StaM)
227 Mc Kea ie Drive
and 1 resided at ~ However I have changed my domic,~le -
(Street and Number)
and am and have been a bona fide resident of the State of Florida since _`--11 ~ day of
APri 1__ , lq 6~nd I reside at 3424 Car lyle Str~et-
(Street and Number)
fORT PIERCE, SAINT LUCIE GOUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicils in the State of Ho~ida.
(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
Bntering chile in 8th Grade
FI ~~y
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I FURTHER CERTIFY that I will oomply with all other requiremenri of a legal reaident of this State.
I FURTHER CERTIFY that I have no intention to return to my former domiGle, and I intend to remsin in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIOA, permanently.
. ti~ti~tt~IN11lJt/~`
• , (Name)
i T: ~ .
O if :
~ Janelle Payne
j1 ::4 ~ (Address)
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• 1 : -
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. z:,., y,- : = April 66
~•~~;'Sw~qi.to'aklr~tibsuibed before me this 12dsy of . 19
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.
ROGER POITRAS
CLERK C! CUIT COURT Notary Public
gy D.C. My Commission expires
(To b~ ~x~cul~d in duplicaf~ and ori~inal fil~d wi1l~ Cl~rlc CirwN Couh, and dupliuN wifb Tax AsNaor.)
aoo~ 143 97 .
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