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TQ Tttf StA~'E AN~ COUNTY TAX A55ESSOR.
Si. LUCIE COUNTY, FLORIDA: *
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T'nis is my declaration of Oomicile aRd CitizBnship in the Sta~e of Florida that 1 am filing ihis d~y in /cordanu and
in oonfo~mity witi~ Chapte~ 222, Saction ~22.17: Florida Statutes.
New Haven Con~e~~ieut
t was formerly a legai resident of -
~C;~y~ (Staro)
and I resided at 11? PEtldlP~on Street However 1 have changed my domidle
(Street and Numbe~) ~
to and am and have been a bona fide r~sident of the State of Florida since _-_S - day of
Nove~nber b6 735 Airoso Bivd, Port St~ I.ucie
_ , 19 and 1 resids at
(Street and Number)
FORT PIERCE, SAINT LUClE COUNTY, IFLORIDA .
and this statement is to be taken as my declaration of citizenship, actual legal res+dence and domicile in the State of Horida.
(Insert he~e any pertinent facts, such as sale of property or business, or relinquishment of employment
at fo~me~ domicile, removal of family to new domicile, purchase of home, etc.)
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Bstablishinq residence ~ y~
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I FURTHER CERTIFY that 1 will oomply with all other requirementa of a legal ~esident of this State.
~ 1 fURTFiER CERTIFY that I have no intentio~ to retum to my former domi~iie, and i intend to remain in FORT
PIERCE,-SAINT LUCIE COUNTY, FLORIOA, permanently.
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. . - Carl Saresky
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~ S~iivom to and s~b~cribed before me this 14 day of rlovembe r , 19_bfi.
~
ROGER POtTRAS
tl t11T COURY Notary Publi~
gy D.C. My Commission expires
~ (To b~ ex~cvrod in dvplicat~ and ori~ina! filed with Clerlc Grwit Couut, snd dvpiicats with Tax Ass~ssor.)
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