HomeMy WebLinkAbout2542 r'~, t 1.~~~~+~~''~1 ,e-~ a ../1~~~ti ~ (~.~F.~..~~~~~ . ~j
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•ro 1~~ i~. sTn~rl: ANU GOUn7'Y TAX ASSI :SSOIt, 2~2043
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ST. LUCIE _L~pUN'fY; I~LOl:1DA: ~ - ~ ~
'fhis is my dcclcuation of Dc~micilc and Citizcnshir in thc Statc o[ riorida that 1 auti filin~; this day in
accordancc, and in confonnity witl~ Scction 222.17, rloriJa Statutcs. .
I~vas forn~crly a legal residcnt of , and I
• . - (c~~r) (s~~~e)
residcd al - S• Lj . tio~vcvcr, I havc chan~;cd my domicilc to
(Stteet and Numtxr)
and am and havc bccn a Uaia Cdc residcnt of the St:~tc of Tlorida sincc day ..af
, 19~~, and 1 residc at / b~ s S ~
t (Stteet and Numbcr)
, ST. LUGIE Coi~nty, Florida,
(ca~r)
and this statement is to be taken as my declaration of citizenship, actual lcgal residence and domicile in the State
or r~or;aa. - ~
(Insert he~e any pertinent facls, such u sal~ ot property or business, or relinquishment of employment at forme~
domieile. ~emoval of family lo new domicile. purchase of home, ete.) ~
Applying 'for homestead : ~ . ~ _ .
. ~ Entering children in school :
l~tl ~
Other: ~ _
~ . -
. ~ ~fLf 6 Rlitfl i~ • -
" si-111CiE CO~NITY~~, !
' . . ' R4C£R Pp~TRA~ ~ ~ •
~ t•~ERlc ~~CW7 COiJAT ' ' - '
' RFCARif Yf 4~Flf 0
I - • '
~ . , .
; ~ ~ ~ 11 ~1 oi P~! '73 -
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~ - - - 262043
I FURTIILR CERTI}=Y tliat I will rcgister at my local address tivhen ti~c registration books reopen, and
comply with atl otl~cr rcquiremcnts oC a lc~al residcnt of this State.
I FURTHCR CERTIFY tli:it I ha~e no intention to return to my former domicilc, and I intcnd to remain in
St~. Lucie , County,
~ Florida, pg~n~ tl~ : (c~~r) ' ~
a' ' '
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9 = "
_ ~ ` J G : ~1 ~ ~ (Name)
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~ ~ ~ - ~ ~ . ~ / (n 2 -s ~ - T
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- ' ~ ~ ~ •IS`~.Fi C~ . .
Sworn to-i+n~ s+d~c.~i~~ bcforc mc ihis _ Z~-! day af
c . . :D. 19__~_3
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):UG~I; POI7'1~/1S, CIJ:l:I: CT1tCU COUItT gCOK~1~ PAGt~JJJ
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