HomeMy WebLinkAbout2131 D~cl~rat~o~j ofi Dor~icite anc~ Citi ~~n~~~;~
263836
~1'U 7'll{: S?A'I~f Ai~l) C'UUN"fl' '1'AX ASSI:SSUIt,
S t . l.uc ie
COUN'I'Y, i~1.Olt1UA:
'tl~is is my ct~claration of Uomicilr ;i;~d Citir~:nship in th~ Statc of Floricta that 1:+ni iilin~ tl~is day in
accordancr, and in confannity with Scrtion ~22.17, F'lorida Stateitrs.
I was forn~erly a 1rg:~1 residcnt of ' ' and I
D (CitY). (Sty1e)
nsided at _[~L~_._1~~~ . However, I have chan~ed my domicile ta
- (Strect and Num~er)
and am and have bccn a bona fide residcnt of the St~te of Florida since day of
now . .
~ ~ , 197~, and I /Fcsidc at
~ _ (Sttest and Number)
,L oh....e . S t. Luc ie
County, F'lorida,
(citr)
and this statement is to be taken as my declaration of citizenship, actual le~al resicience and domicile in the State
of Florida.
(Insert here any pertinent facls, such as sale of property or business, or relinquishment of employment at former
domicile, temoval ot fa~nily to new domicife, purchase of home, etc.)
- 263836
Entering children in school:
ST tUC1E COUpTr FLA~,
ESTABLISHING RESIDENCE ' RK C RCUIT C URT
RECdRD yER:~rEO
. '~1
~ Il 2 03 Ph'1~
w~
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1 FURT~tER CERTIFY that 1 will rrgister at my local address w~hen the registration books rcopen, and
comply with all other requiremei~ts ot a le~al resideni of this State.
I FURTHCR CERTIFY that I havc nc~ intcntion to return to my fom~er domicile, and I intend to rcmain in
/~~~R _ St . Lucie , County, ~
o ~a~ ~3er,~~ancntly. <<"Y~ ~
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J~w L~ • _ i~~ `~s _
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Sworii ~o aizd ~ubscribrd brforc mr thi, da~• of
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J` - - - A.1). 19---73 .
ROG~.R POITRAS, CI.CRK CIRCLtI.T COURT
_
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, n~pt~ty ~rk
(To t~e e~rculrJ i„ ~Iu~~h~.Hr aud I id.~d x~tl~ ( Ir~l. l in uil ('uurl.:~n.l Juplicrle ~citl~ "lat Ati~~•..',ut)
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