HomeMy WebLinkAbout0702 Declaration ot Domicile and Citize~ship
TO THE STATE AND COUNTY TAX ASSESSOR, ~
Sl. IUCIE COUNTY, FIORIDA:
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This is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and
im m~forr.iity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of ___~lETQA-__ OhiO _
(City) (State) ~
f
3094 ~
and ( resided at ~arkle CL1~8~1Og8 F8118 _ . However 1 have changed my domiti~e ~
(Street and Number)
to and am and have been a bona fide resident of the State of Florida since __.-~~~~-27 day of
, 19~_~, and I reside at 3909 So. Indian River Drive i
- (Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, adual lega) residence and domicile in the St~ate of Florida.
(Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment ;
at former domicile, removal of family to new domicile, purchase of home, etc.)
Establishing residency .
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s'
~ILED tiND RECORDED ` ~ t
ST. LUCIE COUNTY. FLA.
~?~C~ VER!FIED . , : - , I
1861U3
! '69 NOV 2 4 P~! I: 0 9
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i?OG£ ~ ~QtTRNS
CLERK C1RCUtT COURT
I FURTHER CERTIFY that t will comply with all other requirements of a legal resident of this State.
~ I FURTHER CERTIFY that I have no intention to return to my former domiu~e, and I intend to remain in FORT
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
~ ~J~- ~
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~ (Name) Robert L. Pettitt
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Betty L. Pettitt ~
F~ i
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Swom.to a~rid subscribed before me this 'Z~ ^ day of . 19~-
~
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ROdER POITRAS
CLERK CIRCUIT'COURT Notary Public
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~ri gy ~ D.C. My Commission expires
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(To be exacuted in duplicate snd original filed witl~ Cl~rk Grcuit Courf, snd dvpliuN with Tax Ass~ssor.)
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