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HomeMy WebLinkAbout0356 . Declaration ot Domicile and Citlzenship TO THE STATE AND COUNTY TAX ASSESSOR, Sl. LUCIE COUNTY, FL4RIDA: This is my decla~ation of Domicile and Citizenship in the State of Florida that I am filing this day in accordance and in conformity with Chapter 222, Section 222.17, Florida Statutes. y Mar land 1 was formerly a legal resident of CheV_ ChzSC_ Y (C;y~ (State) 6700 BrooY~ille Road and I resided at _ _ _ _ . _ - However I have changed my domitile (Street and Number) ro and am and have been a bona fide resident of the State of Florida since ~tb day of June , 19 69, and I reside at 13d6 _ San Suci Lane FORT PIERCE, SAIPlT LUCIE COUNTY, FLORIDA and this statem~~t ~s ~o t3e :aRen as c~s~ ~~:!~:a:=:.~ of citizenship, actual legal residence and domicile in the State of Florida. (Insert here any pertinent fads, such as sale of property or business, or relinquishment of employment at former dornicile, removal of family to new domicile, purchase of home, etc.) l~~gnl~ ~i~~o ~,ric Establishing rea~clence R~~ ~8~~ , t-r1Ct~ ;~'dU ;~7'~,?,'F'L;S. J Applying for homestead ' ~ ~ ~ '~L~ L: i~~ ~ 1 1~ ~ • ~ ~ _'f.`- - - ; • ^:~~'~?T C~URT i ~ i E ~ ~ ~ E I FURTHER CERTIFY that 1 will comply with all other requiremenis of a legal resident of this State. I FURTHER CERTIFY that I have no intention to return to my forme~ domic,ile, and 1 intend to remain in FORT PlERCE, SAINT LUCIE COUNTY, FLORIDA, permanently_ . • ~ . ~ . v.-~.,~•__. ~~s~%Q,-- ~~Q ~ ~ - ` ~~ni @ ~Na~rse Lindsay ~ ~ • ' l. ~ ~ ; , - • ~ ~ ~ (Address) _ . . ~ 7th January 70 Sworn to and subscribed before me this day of , 19 . S ~ ~ ROGER POITRAS _ ~ LERK CIRCUIT COURT Notary Public / ~ By D.C_ My Commission expires 4 (To bs executed in duplicate and originsl ~iled with Gerlc Circuit Court, snd dupliute with Tax Ass~ssor.) BOGK~~z PAGE ~ 3 ~ 354 ~ ' _