HomeMy WebLinkAbout0496 ;
. ~
Declaration of Domicile and Citiz~nship
~ 264'755
TU TlIG STATL•: AND COUN7'Y 7'AX ASSESSOR,
St.Lucie ~
~ _cour,~~v, r•~okiun: 4
~
Tliis is my dcciaration of Damicilr anJ Citi•r.cnship in thc Statr of Florida that t am filing lhis day in ~
~
accordance`and in conformity with Scction 2~2.17, Fla
'd~tutcs. ~
f c ~
I was ormerly a l gal rcaidcnt ~f _ , and I
(Ci~ t e)
resided ~t ~~~2 However, I have changed my domicile to
(Street and Number) ~
and am and have ~ been a bona fide resident of tlie State of Florida since ~ day of
now ~3G ~ r / ~ :
, 19L~ and [ /~reside ai i ;
(Street and Number)
~ ~ . St . Lucie County, Florida,
(c~~r)
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. •
(lnsett fiere any perlinent facts, such u salr of property or business, or tNinquishment of employment at tormer
domicile, removal oi family to new domicile, purchase of homr, e~c.)
~
t
~
. t
Entering children in school: ~
~ , ~ ~
_ ~~~,c~y~~-~v~2~ f _
Lc~,~~~~ _ .u2
264~'5$ f
fILED AM(? R£CURDED •
! ST• tUC1E COUHTY FLA. `
~ R~C: n ~•3f i RAS
~ ~ CLERK ~~;,CU1? COURT '
R. CORt! Vi P±~rE~ '
i ~ / A
~CT ~ ~Q 5? ~ ~ ~
!f ~
ti{ lY r •
! ~
~
~
~ -
~ I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
comply with all other requirements of a legal resident of this State.
~
I FURTHER CERTIFY that 1 have no intention to return to my former domicile, and t intend to remain in
~ ~ S*.. Lucie , County,
~ Florida, permanently. -
~ ,
rJ/J ~ %
~
z~ . : f~ . , p (Namt) CiOe @ .
' - ~ ,n / b th ~-u ~-L.
~ - . a~ s d~ ~
~ : ~ . : ; ~ _ ~nad«u,
'~s' ~ ~ . . ' ' . . !~i : -..1
.
~ Swoin tct arrd;~ bscribed bcfore mr this °Z day of
~ , . . .F , A. D. 19- 7
3
- ROGER POITRAS, CLERK CIRCUIT COURT .
_ - .
_ . ~
. - - . - - -BY--= - - -.~`-e~ _~~rL.e~ R
e Cler
c~- - 800~~~9 ~A~E ~9V
x~ . .
(Tu be exeeWed in duplicrt~• ,,nJ urigma! fi1rJ with ('I.rk Circail Courl, and duplicate wilh 7a~? Assessor)
r~;
;s:
.
~ ;
w..
~ - - ~-~;r
~ c - _ --.s:
_~-~°r_.- _ . - ' . ~ - - . _ _ ~