HomeMy WebLinkAbout0466 ,
Deciaration of Domicile and Citizenship
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7'O THE STAT~ ANU COUNTY~ 7'AX ASSESSOR, ~
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_ St .Lucie COUN'1'Y, ~LORIUA: ~
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Tliis is my dcclaration of llomicilc and Citizenship in thc Statc of Florida th~t 1 am filin~ this day in
accordance, and in conformity with Section 2'_'2.17, Florida Statutes.
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I was formerly a legal resiclcnt of _~~.,.~!~L~~~ , and 1
r----~ ~ (citr) (St.te) -
resided at ~,2~ 7~~ ~0'~~~i . However, 1 have changed my domicile to '
(Street snd Number)
and am and have been a bona fide resident of the State of Florida since rly'~ day of ~
now ;
_ , 19_~, and I /~cside at L~4 ~ ~o~~~ ~J ~
d (Street snd Number) ,
St . Luc ie County, Florida, {
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(~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State :
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of Florida. ~ ' ~
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(Insert here any pertinent facts, such u sale of property or business, or relinquishment ot employment at former j
domic~7e, temoral of family to new domicile, purchase ot home, etc.)
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Entering children in school: .
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; ST. ~uC~E ~auNTr fLA.
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~ CLEr a,_y..:: UI~ CCURT
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pct l 9 02 AH'73
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I FURTHER CERTIFY that I will register at my local ~ddress when the registration books reopen, and
comply with ail other requirements of a legal resident of this State.
I FURTHER CERTIFY that f have no intention to return to my former domicile, and I intend to remain in
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~ ' St . Lucie , County,
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~ Florida, permanently.
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(Nam!)
l~'?' a~o~~ a.~P_ . -
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~ Sworn to anc~-sNi~~~bcforc mc this day of ~
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t/' •c • A~= , A. U. 19__ 7 3_.
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~ - , ~ ~CLERK CIRCUIT COURT .
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