HomeMy WebLinkAbout1248 Dectaration c~~ Domic~~~ ar~d C~~~ze~ship
TO TNE STATF AND COUNTY TAX ASSI:SSOIt, ~
s t . ~.uc ~e 265291 ~
_ _ COUNTY, F1.ORl1)A: ~
This is my drelaration af Uomicilr and ('itiz~~nshi~~ in th~ Statc of Florida that i am filing ihis day in ~
~
accardance, and in conforn~ity with Section ~2~.17, Flonda Statutes.
1 was formerly a legal resident of ~~eC~~~.._ ~%~x~L~~ ~ and f
_ - _ (ei~r) (s~aee)
^
nsided at ~ . However, I have changed my domicile to
~ (Street an umber)
and am and have bcen a bona lide resident of tiie State af Fiorida since L~'~' ~ 73 day~ of
,
now ~
~,,C'~ l ' , 19~~, and I /~residc at _ ~ ~ G~ • ~
~ (Strcet a d Nu r) ~
. S t. uc ie County, Florida, 4
(cti~r)
and this statement is to be taken as my declaration of citizensl~ip, actua! lega! residence and domicile in the State
of Ftorida. •
(Inse~t here any pertinent facls, sucA as sale ot property or business, or relinquist?ment of employment at former
domicile. temoval of tamily to new domicile, pu~chase of home, ete.) i
!
. t
Entering children in school: .
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$~~~~OVE~R~
. RECO
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F~~ ~~i/Rt ~ ;
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r 8 9~2~,?3 i
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I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and f
i comply with all other requirements of a le~al resident of this State. r
~ I FURTHER CERTIFY at I liave no intention to return to my former domicile, and I intend to remain in
~
_ ' ' St . Lucie County,
~ Florida, permanently. «''y~ f~i/a/~s ~
: i .
- :
``~ti;~ i ~
; : ~ t j ~ , a' C~ . ,
• ,._~V~.;~ Ga'.; (Name)
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~J'~`' ~ Jt3
' G~ ' b(Address)
! S~i?ohi to: an s~. ~d bcforc mc this ~ da of
: : x ~ ,~~;e~ Y -
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t A. D. 19-_ 73
- ROGE~~~I~OITRAS, CLERK CIRCUIT COURT
~ - ~
_ , ~y De 4t ""~~e k~_ ~';;~''~~9
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(To,be eaecuted in dupliraic and ~~~i~;in.d d M~tt~ ('IrrE. ('ircuit Cuu~t, an.1 Juplirate aiih Tax A«t'iGN~ ,
;
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