HomeMy WebLinkAbout0518 Declaration of Domicile and Citi~~~~~i~
TO TNE STATE AND COUNTY TAX ASSESSQR, •
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St . Lucie ` _ _ COUNTY; FLORII)A: #
This is my d4clar.~tion of Qomicile and Citizenship in the State of Fiorida that ! am filing this day in ~
. ,
acconfance, a~~d in cor,l'ormity with Section "'2?.17, Florida Stats~tes. ;
1 was formerly a I~g:el resident of ~ ~ "
, ~ ~ ~ and 1
, I - i ~~Y) (State)
n;sided at s ,,,i ~ t!~-~Y~N~.._ ' . However, 1 have chan~ed my domicile to
(Siteet and Numtxt) ~
3nd am and have bc,~ n a bona ftde resident af the State of Flo ' a since ~ day oi'
, "l ~ ~..6.e~... ~s-4-az~S - -
1 y_1~ and i rc~ide at ~~~t.~.X7~3[.Q... ~o~-~
' / _ ~t~eet and Number) '
- . b~'f Cout.~y, Florida,
(citr ) -
and this sta ement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida.
(Inserl here any prrtinrnt tacts, such as sale af ftoperty or businrss, or relinqu~ment of empioymrnt at lormer
domicite, removal uf tamily !o new domicJe, purchase ot home, rtc.)
o~ - ' ~ ~ s .
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F11ED ~l~D RfvYRy~~
fT.LUCI[ CduMir F"~ -
ROCER r~~IR1S
cL~g~c ~;~cu,r coueT~,
- I~Ft~IA^ Vf:~t~~f0 GV
fEe 10 3 e~ P~'?3
248141
1 FURTHER CER'TtFY that 1 will rerister at my local address vohen the registration books reopen, and
comply with all other requirements ef a le~al resi~en~of this State.
~
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1 FURTHER CERTIFY that 1 have no inten to return to my former d icile, and 1 intend to rcmain in
t , ~ . .
~ ~ , County,
Flori , permanently_ cc~e~t
- ' - !e~~~~y--Z---
(Name)
KR,'st~Ne ~1el~e~t -
• (Address) !
'r \j ~ t~f~ ~ ~ i
~fie , ;
S~v~zn:t8 and cct ~~ri'b~~hefore me ti:is __°_-'d_ day of
~ J ' 4
- _n~R~` :4 ~ A.D. 19?
t~ ~ ~ y ' ~
: 73 \
~vv ,JL,/t.~Q t
Not~,~u~iic State of Flori at Largr s
. . ~ 5i8
" l ~ 73 da~c~~i.
My Commi-;iv~ezpires- ~ -~-r------
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(Ta be executed in duplicate and on~in~l filed ~vith Cterk Citcuit C~wrt, and duplicate wilh Tax Assessorj
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