HomeMy WebLinkAbout0527 Deci~ration of Dornicile and Citizenship
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"f0 THE STATG AND COUNTY TAX ASSI:SSOR,
St.Lucie __COUNTY, FLORIUA: ~
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Tl~is is my dcclaration of Uomicilc and Citixrnship i~~ thc Staic af
Florida that ! am filing this day in '
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accorclance, and in conformity with Section 222.17, Florida Statutcs.
1 was formerly a legal resident af ~ ~ s and 1 .
(City) (State)
resided at ~.~Q~ ~~~~en~ P r' ~l 3 . However, I have changed my domicile to •
~t snd Number)
and am and have becn a bona fide resident of the State of Florida since ~ ~t f~ day o1~
now
cZ~ - , 19?3 and 1/lreside at ~i ~ ~ C e. ~A1 ~ U c ~k 7
~ (Street and Numbet) i
e rC ~ St. Lucie County, Florida, ~
(c~tr) ~ }
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State ~
of Florida. ~
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(insert here any pertinent facts, such u sale oi property or busineu, or relinquishment of employment at forme~ ~
domic~7e. rrmoval ot family to new domicile, purchase of home, etc.)
Entering children in school:
l o ~~e h s~i e a c+~ ~ 3~ ~
J e ~('e y Oe~~ . ~
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FIlEO ANC 3f C~n0E0
ST.IUCIE i;uUNiY FLA.
ROCE^ %~IT4AS
CLERK C ~:Jlt C~URT
p~~nR? v=_F>;.ED._...._..~
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Oct i !`l 44 P~'73 .
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1 FURTHER CERTIFY that [ will register at my local address when the registration books reopen, and ~
comply with all other requirements of a leg~t resident of this State. ~
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~ r I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in ~
~ I C~ 1`C ~ ~ St . Lucie , County,
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Florida,•perrpaneptly. ~
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~ ) . • I. ~ ~w : i: ~ (Name) ~
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_ ~ a~ . _1 ` . [O ~ ~ ~ .L~.~C -
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~ ~~~?o~i:f~~atia ~~cribcd before me this day of =
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r ~~-~c it/ A. D. 19_ 7 3_. ~
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~ ROGER POITRAS, CLERK CIRCUIT COURT
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-BY---t~~ - . I~
~ Deputy Cl~rk
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r (To tx cxrcutcd in Jupli.alr ~nJ urigin.il f~led wilh l'Irrk ('ircuit C'ourl. anJ Juplicalr with Taa A~sc~~nr)
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