HomeMy WebLinkAbout2100 Declar~~ion of Domic~~~ a~d C~tize~~hi~
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"1'U 7'tit: STATI: ANl) CUUf~'l~Y 1'AX ASSt:SSt)It,
_ST._ LUCIE ~•pUNTY, I~LURIUA:
Tl~iti is my dccl:iration ~~f 1)omicilc and Citir.cnship in thr Si:~tc of rlorida that 1 am filing this day in {
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~ccordancc, ~nd in confonnity with Section 2~2.17, Florida Stat~~tcs. ;
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1 was fornicrly a legal resiclr.nt of Q~ /~(.LX,_~ and 1 i
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resided at ' . However, I have changed my domicile to !
cs~~«~ N nr~~ Cd
and am and have bcen a bona fide resicicnt of ti~e State of Florida since day of
_ , 19 and 1 reside at ~Q ~
r~ (Street and Nu er) i
St . Luc ie
i',tA~t...c ~ , County, F da, ~
(citr)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Fiorida.
(insert hcre any perlinent fatts, such u sale ot property or Dusi~ess, ur relinquishment of employment at focmet
domitile. remoral of tamily to new domicle. purchase ot home, ntc.)
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FtLED ANO RECORDED
St. LUCIE COUNTY FLA.
RQGER 'r01TRA5 ~ ~
CLERK CInCUI~ COURT
RECORO VERsF1E0.~~. #
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~ Ju~ l3 2 03 PN'73
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I FURTHER CERTIFY that 1 will registcr at my loral address when the registration books reopen, and
~ comply with all otlier requirements of a Icgal residcnt of this State. .
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I FURTHER CERT[FY that 1 l~ave no intention to reti~rn to my former domicile, and I intend to remain in ~
~ St. Lucie -
~ - , County,
Florida, permanently. tc'~'~
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(Name)
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r S~v s{~t~j~ .hd'om me this~ 3__ ~ay of ' ;
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3~.: ~y ~
- ~'s~ - D. 19_Lv ,
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' j.~i~',~~r~LERK OF CI CUIT COURT - i
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~ By,. , ~E; 1)eluty Cl.erk ~~s MI~E~~ {
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(Tu br rxrcuted in duplic:dc a~~d ori~•in.d Id~•.1 ~.ill~ l'I^rA l ~tcuil ('uurt, anJ alupli:at~ w~ill~ lrx AcKSwr)
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