HomeMy WebLinkAbout0029 , ~
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t9~~l~ratlon oi D~mi~ii~ an+d ~Itiz~~ship
TO THE ~TATk AND COUNTY TAX ASSESSOR, ~„~,,`,r~`,'~'t~ ~
Sl. IUCIE COUNTY, FIORIDA: ~
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. . - - - . • . • - - r ~~__•J, •L..• 1 ~m f:l:r~ J f{~ie t~av in accnrciance and
T~115 IS my declaration ot Uomiciie df1C1 I,IflLeli111iN ~ii ii~t; ~i6i~ Ui i~viiuc .
+n conformity with Chapter 222, Section 222.17, Florida Statutes. ~
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I was formerly a legal resident of Urit ~ ip_ Canada 4___ _ i
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23 La u a ~
and I resided at _ - - - y - g _ - _ - , . However t have changed my domiGile ~
(Street and Number)
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ta and am and have been a bo~~a fide resident of the State of Florida since _ 20th day ot ~
_ October__-. t9__-- 6~,d ~ reside ar _3018_5unrise ~lvd,
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(Sfreet and Number)
FQRT PIERGE, SAINT LUCIF COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, act~al legal residence and domicile in fF~e State of Florida.
(Insert here any pertinent facts, such as sale of property or bus+nass, or relinquishment of employment
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at former domicile, rernoval of family to new domicile, purchase of home, etc.)
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Applyin~ for homestead ~~~p ~~,3 REr~RDEO -
Ut~ICIai~ECUTd BOOK y
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~ ~r~=_ . ' JAt~ 2~1 P~1 ~ . 51 ~
, ~ - i,: _ 66 ~_~~~f j ~
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' ~ < . t~OGEf< r~?"~ R;~S. CLERK
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S7. LUCIE COUNTY.
; - • . FLORIOA ~
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Alien # A 13-367-924 s
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I FURTHER CERTIFY that I will comply with all other requirements of a legal resident of this State. t
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I FURTHE2 CERTIFY that I have no intention to return to my former domiCile, and I intend io remain in FORT ~
PIERCE, SAIMT„kU~IE COUNTY, FLORIDA, Fermanently. . ~
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. ; - ~ (Name)
- _ „ ~ - John Hilling Martip
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! Sworn to and subscribed before me this ~ 24th day of - Janaury 19 b6
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( ROGER POiTRAS
' lERK CIRCUlT COURT Notary Public
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! B D.C. My Commission expires
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(Ta be executed in duplicate and original filed with Clerk Circuit Court, and duplicate with Tax Asssssor.)
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