HomeMy WebLinkAbout0795 ~
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ueclar~tion of Dor~ic~i~ ~nd Citi~c~nsh~ip ~ ~
TO THE STA~E AND CUUNTY TAX ASSESSOR,
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Sl. IUCIE COUNTY, FLORIDA: e
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Ti~is is my declaration of Uomicile and Citizenship in the State of Florida that I am filing this day in accordance and ,
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in conformity with Chapter 222, Section 222.17, Florida Statutes.
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I ~vas formerly a legal resident of WinStE;d COnn"
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and I resided at ___._1582 _~Qyd $_txe_~_~___-___________-- _ . However ! have changed my domi:,ile ~
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(Street and Number) ~
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to and am and have been a bona fide resident of the State of Florida since ___1Q_th day of ;
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September _ ~q hs_, and I reside at __110 Camin~ St. River Park ~
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(JIICGI oiiii I`YVIi{LTaii(
FORY PIERC6, SAINT tUCIE COUNTY, FLORIDI> ~
and this statement is to be taken as my declaration of citizenship, actual tegai residence and dom~cile in the State of Florida. ~
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(Insert here any pertinent facts, such as sale of property or business, or relinquishment of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.) ;
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~pplying for homestead ~
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~ I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this 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 ~
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. ~
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~ '•~C' (Name) f j
dam Marqui ~
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. = Juliette M l~iarquis x
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Sv,for«-toyand'subscribed before me this 14th day of January ~ ~q b6
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ROGfR POITRAS - ~
RK CIRCUIT C URT ~ Notary Public
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gy _ D.C. My Commission expires ~
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(To be executed in duplicate and original filed with Cierk Circuit Court, and duplicate with Tax Assessor.) ~
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