HomeMy WebLinkAbout0467 Decfaration o~ Domicire and Citizer~ship
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TO "fttE STATL: ANU COUN~'Y TAX ASSl:SSOIt, 264'733
_ St . Luc ie COUNTY, FLORII)A:
Tliis is my dcciar.~tion of vornicilc and C~iurnship ii~ the Statc of Florida that 1 am filing this day in
accordancc, a»d in conformity with Section 223.17, l~lorida Statutcs.
1 was fo~erly a Icgal residcnt of ~ S~/ ~n«~fA O~i ,_/~p,,,~ ?/orl~( and I
/ cc~~r~ i ~s»~_
resided at _.L~_ ~~~~~/flD d/q?~- . However, 1 have changed my domicile to
(Street and Numt+er)
and am and have been a bona tide residcnt of the Statc of Florida since aZ a y day of
now
, 19_ ~
3 a»d 1/~esidc at ~A~^ O~v LA~/ ~
~ (Strcet and Number)
_ P~r 1~ ~f L K c~~ . St . Lucie County, Florida,
(c~~y)
and this statement is to be taken as my declaration of citizenship, actual legat residence and domicile in the State
of Florida. ~ -
(Insert here sny pertinenl facts, such u sale oi property o? busincss, or relinquisAment of employment at lormer
domicile. removal of family to new domicile, purchase of home, etc.)
Entering children in school:
~ 264'733 -
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FILED At+" RECOROEO •
ST. LUCIE ~OUHTY FIA.
RU;E? r'Oi'RA$ ~ :
CLEaK v~~CU1T COURT~ ;
RFC4Rp Y~ ~ jf iE0 ~ ;
Oct I 9 09 AH'73
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I FURTHER GERTIFY that 1 wili register at my tocal address when tne registration books reopen, and
com~Iy with ali other requirements of a legal resident of this State.
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and I intend to remain in
/UaY7- CH~,'~ S*.. Lucie
, , County,
Florida, permanently. «''y~ .
• ~ if G/ ~ A~t A/l~~n
~ L v.,~. (Namt) ~
~aJ`~', cL~ , _ `I ~ ~ ~r _ ~iS~ p ~f ~~-c , ~ .
- .•i:~ ~ j. p ; s) ' - a ~ r~N ~ / ~ e
- ? ~,~~.~Q • G : = ~ (Address)
~?n~ .~r;~~ :
1.
~~'`yvt~ t~~'~~ ~t}~~cribcd bcforc mc this Jay of ~
~ t ,."~C~:~~~ .
~ A.D. 19__~.3
~~:K~.~G~R pOITRAS, CLERK CIRCUIT COURT
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~y _ .CJ- a~oK~~.9 ~~E ~fi?
~eputy e
rk
(To lx c~ecutrJ in du~~l~ralr aod ur~E•iu.d filcJ ~~rth 1'Irrk C~rcuit Coutt. a~iJ Juplicalr ~~ilh Tax Asscssur) -
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