HomeMy WebLinkAbout1263 Declaration of Domicile and Citizenship
231651 .
TO THE STATE ANU COUNTY TAX ASSE:SSOR, .
St. Lucie COUNTY, FLORIUA:
Tl~is is my dcclaration ot~ Uomicilc :~nd ( itizcnship in thc Statc of Florida that 1 am filing this day in
accordancc, and in coni'ormity with S~~ction ???.17, Florida Statutcs. ~
1 was formerly a legal resident ot~ Kgt~.~hi Pr~Yi s•g.n- aiid I
(Ci~r> (sute)
n~sided at _7_~,~____$~pc~._2-.__. __peeha__- . However, 1 have changed my domicile to
(Strret and Number) ~
~
and am and have bcen a bona fide r~siclent of the State of Florida since day ot
__Agt~~--- . 19_Zl_, and 1 r~side at Rt___4 Bo7[ _680
(5treet and Number)
Ft. Pierce County, Florida, ;
- - S . Luci e
cc~i>~ ~
and this statement is to be taken as my dcciaration of ~itizenship, actual tegal residence and domieile in the State '
of Florida.
llnseri here any {+rrtinrnl facts, such as sale of property or businru, cx relinyuishmrnt ot rmploYment at turmrt
domicile, removal uf tamiiy to nrH• domicile, purchase of home, etc.)
Khalid &:ahmood KY:an has been livin~ rere for the last 14 months
and i~ attending t~:e Indian River J~nior College.
He will apply for Anerican Citizenship upon co~pletion
of Indian River Junior College
He has in hiG posseeaion a Student Yisa, Classified ss F#1
~31ss~
STI~
CiE COUMTY F~~
ROCE" r~tT~iAS
" CLERA C~~~ru~T COURT
RFC09C~ Yfr ~lEi~
J~ ~6 2 ~2 PH'11
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I FURTHER CERTtFY that 1 wiU register at my lo~al address when the registration books rcopen, and
comply with all other requirements ot~ a legal resid~nt of this State.
1 FURTHER CERTIFY that i havr no intention to return to my forn~er domic+le, and 1 intend to remain in
Ft. _ Pierce St._ I,ucie__ County.
- _ - - - -
Florida, permanently.
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~ ' (Name) - - - - _ - -
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~'$v~orn tq.arta.siibscribed hefore me this 1~ ~
_ d~~y of ~
1- _ Jttne A.[). 19 72 .
, J _ _ -
c i .c-~t~-~ ~a~-2_ ~~-G~i ;
~__~+{ota~y Public Sts f FWinda at Laree
hty Commission expirrs _ _`~-`t~' /Sr ~f~r0 ~
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(Tu be r~ecutrd in Jupbca~r anJ uriF~nal [ilyd N~th ('IrtA CGCUit Coutt. and.duplicate w~ih Taa rlsxsux)
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