HomeMy WebLinkAbout2794 Declaration of Domicile and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR, 2'4~s~~
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-t.c-t~c~___ COUNTY, FLORIDA: i
Ttiis is my declaration of Domicile and Citizenship in the State of Florida that 1 am filing this day in ~
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accordance, :~nd in conforn~ity with Section ~?2.17, Florida Statutes. ;
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1 was formerly a legal resident of ~
(City) , State }
residrd ~t °y~__~~ . However, I have changed my domicile to
(Street and Numbrr) ~
:~nd am and havr txrn a'bona tide resident of the State of Florida since day of
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_ ~-~-~-~4~u . 19 ~
~ . and 1 reside at ~ 6~ ' - ;
~ ~ (Street and ~mber) t
~_~~.t~._C._ _ ~-u-L County, Florida,
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and this statement is to be taken as my derlaration of citizenship, actuai legal residence and domicile in the State
af Florida. '
(Inserl herr any prrti~~.~: facts, such as sale of property ot businrss, or relinyuishment oi employment st former
domicile, removal ot family to new• domicile, purchase of home, etc.)
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24'76'7'7
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FILED Aka RECORDEO
ST. LUC~E COUNTY FLA.
ROCER PO~TRAS
CLERK Ct~~UIT CQURt ~
RECORD YEP.'F!E'J.,,~.~
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FE8 IZ I 22 PH'73 ~
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~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
~ comply with all other requirements of a le,al resident ot~ this State.
~ 1 FURTHER CERTtFY that 1 have no intention to return to my former do icile, and I intend to remain in
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~ • `.~c"~Jc~- • County,
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~ Flq~~1~~,~ermanently.
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~ ~S~y~~ ''~Kr~~~ibscribed before me this f~'_.. ~lay of
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~ _ ' '~r'2` - - - , A. D. 191 -
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~ ary Pubiic State o Flurida at Larec ~
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~ bty Commission expires_ _ ~
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~s (To tx exrcuteJ in duplicale anJ unginal fi1rJ with l'Irrk Circuit Court, and duplicate Nilh Tax Assessor) ?
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