HomeMy WebLinkAbout1705 Declaration ot Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR. 1'743'71
Sl. lUC1E COUNTY, FIORIDA:
This is my declaration of Domicile and Citizenship in ths State of Florida that 1 am filing this day i~ aooordanoe and
in oonformity with Chapter 222, Section 222.17, Florida Statutes.
1 wss formerly a legal resident of Kansas Cit~/ I~.LSSOUri
(Ciy) (Sta»)
and 1 resided at W- _83r No th _ . However 1 have changed my domidle
(Street and Number)
to and am and have been a bona fide resident of the Stab of Florida since 12th day of
I~Larch ~9 68, and I resida at ii1l~Jasmine Ave Ft~ P±erce
(Street a~d Number)
FORT PIptCE, SAINT LUCIE GOUNTY, RORIDA
and this statement is to be taken as my decla~ation of citize~ship, actual legal residence and domicile in the State of Horida.
(Inse~t he~e any pertinent fads, such as sale of property o~ business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.)
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1 FURTHER G'ERTIFY fhat 1 wil) comply witfi all other raquiremenb of a I~sl resident of thts State.
I FURTHER CERTIFY that I have no intention to retum to my former domiCile, and I intend to remain in FORT
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PIERCE, SAINT IUCIE COUNTY, FLORIDA, permanently. ~
~ ' ~ • , ~ - ~ ~ CARMBL SMITH SR . ~
. _ - (Name)
, -
~ = ;-~j~: ` ' ~ . _ 1111 Jasmine Ave. Ft. Pierce, Fla.
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: ; (Address)
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.3worn torand subsuibed before me this 31 Stday of n~a X . 19~?9
ROGER POITRAS f
CIRCUIT COURT Notary Public
C
gy D.C. My Commission expires
(To b~ ~x~art~d in dvplicat~ and ori~inal fi{~d wilh C1KIc Grarit Court, and duplicaN with Tax Afsa~or.) ;
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