HomeMy WebLinkAbout2411 , ~i
Dect~ratian af Domicile and Citizenship
TO Tt1E S'I~ATE Ahl) COUN7'Y 7'AX ASSI:SSOR, 26s229
~St.Lucie " _COUNTY, FLORIUA:
This is my dcclaration of Domicilc and Citizrnship in thc Statc of
Florida that I am filin~ ihis day in
accordancc, and in conformity with Scrtian 2~2. l7, Ftorida Statutcs.
~ O!' u s C~1 i 7~-i 'C'
1 was fonneriy a Icg~l residcnt of ~ s , ~ X Q S and I
r--- (c~~y) (s~,~e~
resided at >Yas~ ~i~'~i h e R-~ . However, I have changed my domicile to
(Streel and Number)
and am and have been a bona tide resident of the State of Florida since ~'~5 ~ day of
~ now
~Cf~ , 1973 , and 1/lreside at ~~Q e ~~o ld5
(Street and Numbe
~pr f' 1_ u C;~ . S t. Luc ie County, Florida,
~ (c~ir)
and this statement is to be taken as my declaration of ciiizenship, actual legal residence and domicile in the State
of Florida. ~ "
(Insert Aere any pertinent facts, such as sale ot praprrty or business, or telinquishme~t of employment at former
domicile. removal of family to new domi~ile, purchase ot home, etc.)
. Entering children in school:
c; a:, a Ie 1 a~
~
~ D AqD 8fC
~LUCIF COl~Iri~,
+~os ~ ~ aa~Tw?s l
CiERK C~~LUtT ~p{~T
RECORO YERtF'~f0~~~
0~ !T 10 0~ ~1!'73
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~ 26~229
~
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I FURTNER CERTIFY that I H-ill 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 I have no intention to return to my former domicile, and I intend to remain in
~ St. Lucie
~ ~G~ f- ~7`. ~u c_~ _ , County,
~ Florida, permanently.
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~ I~ ~S. Q~..( ~a~
, - (Name) -
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~ •~`~;;L~' CO•~:.;~:.~~ ~ _ .
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=,'4~':•.'• (/rJ"'% , ~Ad ss)
• y"..,: :.~1~,_.. f.k
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~ ' - r. /.c;f f, . -
~ ~v+ ~t",~nd sitli~ ~c bcfore mc this ~_7 - day of
• RT~,,.,,~ _ ~ =,f~
~ ' ~r~; `
~ y~+ • -'::t~i?`7"o~1-e~.---~ A.D. 19__73_. }
~ ~E~; `~Fd1~~AS, CLERK CIRCUIT COURT .
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_ ~ ~ i~~,. ~.o~k ~19 YAf~ 24~0
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~epu~y -Cler
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(Tu be exrcutrJ i uphralr rnd un~:~n.d tilc ~+itl~ ('Ictk 1'ir. uit CuuN. anJ Juplicate wilh 7ax As~essor) ~
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