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HomeMy WebLinkAbout2427 Deci~ration of Domicii~ and Citiz~ns~ip TO TIiG STATG AnU ('OUNTY~ 7'AX ASSL~.SSOR, 26s~38 St .Lucie_ _ CUUNTY, FI.ORIUA: Tl~is is my drelaration of Uamicilc .~~~a c~c~~,:~~sn;n in lhc Statc of Florida that 1;im filin~ this day in accordance, and in confonnity with Section 222.17, Florida Statuics. 1 was forn~crly a Icbal resident of _ ' and I (c~~r) (sa~~) resided at (~~AJ4/ ~aS~~t~2 'rvT~~/d~o ~ C~.t6 a . However, I have changed my domicile to (S reet and Number) and am and havc becn a bona fidc residcnt of thc Statc of Florida since day of now , 19-y and I/~cside at ~~~6 ~~~P~'~ S T (Street and Number) J~D ttT/t ~ R T ST• ~/~C/ /s , St . Lucie County, Fiorida, (c~~r) and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Florida. ~ (Insert here any pertinent facts, such u sale of pruperty or business, or relinquishment of employment at fo~me~ domicile, remoral of tamily to new domicile, purchax ot home, ete.) , ~s'~'`'~' ,t Y /a y ~ d ~ ~ ~J I ~o .L, ; T ~9- s a ~ v~ ~ ~~r ,E 1~F. ~~~~O~F~ G~Id~~lN~ Q~~r~.ts i~7-T~rF y.t• N~ S P v .~a,..a ~3c~y ~'ct ~G ~y'~n~erin childfen in school: D g ~ FILED ANO RECOROED ST. LUCIE COUMTY fLA. ROCER POItRAS ~ CLERK Ctn^GUIT COURT ; RECORR 1fERIFtEO ~ OCt 1T IO 38 AM'73 ~ E , ~ zss23~ ~ ~ v ~ . I FURTHER CERTIFY that 1 will register at my tocal address when the registration books reopen, and comply with all other requirements of a legal resident of this State. I FU ER CERTIFY that t l~a no intention to return to my former domicile, and I intend to remain in ~ ~-;1~!` ~-tul ~ St. Lucie , CountY. ~ Florida, permanently. ~c~~r~ ~ ' ~ - ~ `,•`(iN(t~ffl~~~~..t ._•s' . ~ ' " ~.~`-~`U ~~-.,°C ` aiYV~ ~v ~ •~~y~~~ ~ '•.,yr ' Name) ; ,~~ry~il~f f. G~y ~ ,i~'~' p' ! + ~ : , c J' y - i/~~m f ~ r ~ f N ~ ~ ~•Y'~• • a ~ - - (Address) ;'r~z = ,:;x C . _ t- ! !q . - - ~ ~5'v~~~i<~a d~ ~ ~5~~~~bctorc mc tl~is _ , day vf , ~ ~ - • .;w,>^'~' - . G~ _ c~ 73 - ''L.,,-~r-~-''.~f''_------• A.D. 19-- ~ROG~'~"~''OITRAS, CLERK CIRCUIT COURT ~r - - ~ . . . _ ~4 . nX ~ _ ~ `eputy Cler 30G~ r~6C~~~~ . (Tu bc cxcculcd in Ju~,li~ ~tc rnJ ~~ni~in.~l fil.• ~~h ('1.•rk ('ircuit l'aurt. anJ Jupliralc Nilh 7'ax Asxswr) ~4 i ~ "-k-?