HomeMy WebLinkAbout1703 Declaratlo~ ot Domicile a~d Citise~sh~p 2~~6~9
TO THE STATE AND COUNTY TAX ASSESSOR, E
Sl. LUCIE COUNTY, FLORIDA:
This is my declaration of ~om~ule and Cit~zenship in the State of Florida that I am filing this day i~ accordance and
,n co~formity with Chapter ?22, Section ?22.17, Florida Statutes.
I was fo~merly a legal resident of ~eth@1 _ Q~1~Q_-__ - :
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(Ciry) (State) ~
and I resided at ROU ~e _ 3 _ _ _ Noweve~ I have changed my domicjle
(St~eet and Number)
!o and am and have been a bona fide resident of the State of Florida since 14t _ day of
i
Se teober 7 2305 Elizabeth Ave. ~
p . 19__ . ~nd I reside at _ _ _ _ . {
(Street and Number) ?
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaratian of citizenship, actual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as saie of property or business, or relinquishment of employment
at former domicile, removal of family to new domicile, purchase of home, etc.) 4
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Eatablishing reaidence
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' I FURTHER CERTIFY that 1 wiH comply with all other requirements of a legal residenf of ihis State.
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; I FURTHER CERTIFY that I have no intention to return to my former domi~ile, and I intend to remain in FORT
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n~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. {
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~ . _ . (Name) ~
~-j I,eaZie l~artin
. . ,
: . ~ ,
_ - . ~
- ' Carrie Nartin
u Sworn to and subscribed before me this 6th _ day of - JanuArv , ~q~_.
- ROGER POITRAS
C K CIRCUIT COURT Notary Public
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By _ D.C. My Commission expires ~
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(To be execut~d in dupticate and originsl filed with Clerk Circuit Court, sed dupliute with Tax Assesso~.) ;
aoo~ly8 PACE1701
_ No ,3
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