HomeMy WebLinkAbout2843 De~ta~a~i~n af l~or~:;~~~~ ~ ~3~i~~~:~~ 5~9
i) '1'! IL• STATG AI~I) CQUi~l7'Y TAX ASSI:SSOtt,
St.Lucie
COUN7'Y, t~LUlZII)A: ~
71~is is my dcrlar.~tion of 1)omicilc and Citi-r.cnship in ihc Statr c~f rlorida ihat 1 am filinb this ~l,~y in
a:corclancc, .u~d in confurn~ity with Scctian ~22.17, Flori~la Statutrs.
1~vas form~rly a lcg.~i r~s~a~~~t or iv~-t~JFa 2 7 NL-~1 s ~ U1 ~i t/~ //9 and 1
(c~~r) cs~~~~~ .
r~~sidrd at ~`5-5 ~~~"J ~`~L~ ~2 . Hawcvcr, I have cha»gcd my domicilc to
~ (Street and Number)
,~ncl am and have been a bona fide residcnt of the Staie of 1=lorida since ~'S?~ day ot
, ~ 70 C3 L= ~ , 19?
3 and I/rc iclc at 3 2~" J nJ C~ tti 3
(Street and Number) J
,-'i~ ~ 7 S%_ L~c J~=~ St. Lucie ~ ;
, County, rlorida,
_ _
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and this statement is to be taken as my declaration of citizcnship, actual legat residencc and domicile in tt~e State ~
of rlorida. . '
(In~ert here any pertinent facts, such as sale of property ot business, or «linquishme~t ot employmenl sl former Q" t~ d
j^J~
dd~c~e. rcmoval ot family Io ne?v domicile, purchase ot home, etc,) ~ ~ NL- W S S/~IP
~ L ,Llni c;~ r,t ~S ~~i,~i~ j L-~'~P~.-D~ .~.:-•~7~ .A ~ ^~r`.?('v - ~-a,2- r J `
D!' l~c+ ~ K Ca ..^-r~/ ~/Zc_- c_.~- ~P t~`7~ .~~,~1 Q/--o y I~'~.'=ni T # w l 7tf ~
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'd ~1.~~ ~3-- .t 1 C, N -r C'a, - _ f
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Entering children in school;
.1 + .rn ~ r,~t ~ ~.C Z ' :
~V r1J ~
y~ v ~ r~ ~ y
. ~665~9
FIIED AN[~ NECOR~EO ; F
ST.IUCIE ~OONTY fUl. s
- Rt~ofe~l~i+,AS ~ :
Cl:~f Cf~:CU?r COURT
~ RfCt}k , Y~:FC 1`
~ Oct ~t I I 48 aM'13 -
- ;s
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I FURTHER CERTIFY that I will re~istcr at my local address when tl~e registration books reopcn, and
co~ziply with all other requirements of a le~al resident of this State.
>F
f , s~
I rURTHER CERTIFY that I have no intention to return to my fomier domicile, and I intend to remain in
i
r'~ ~ / " S= ~ % ~ tti~_ l L S* . Lucie , County,
f~ lorida, pcrmanently. (c~~r> . , ~
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(Tisme,
. 3~ S" J v...~ c.~- ~t.. ~,c-- .
- (Addreu) t 4
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: Sworn to ~i~~ `~-..~e~bc£orc me this y of
~ J~ ' ~~~p ' ~ ' :
~ *r _
, A.D. 19- 73 , . i'
7.
RUG~~•''~~ ~-~tA`~';: ~:ERK CIRCUIT COURT .
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: ~ - 219 28 ` , :
: _ _ :~~a,.~;::~h'~ `~~2~ i~~~ ° k ~ 4~ -
~ . . . - - ~~K ~
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' Deputy ~Ier
• 1 ' - .
(Tu bt eaeculed in Juplicalr and urig~aal fdr Nith ('Ir~i. C~rcuif ('uurl. and J~yrh. rlr seill~ '1.~~ Asxswr) ~
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