HomeMy WebLinkAbout1723 ~ecfar~at~an of Qor~~E~ile and ~~~i~~~r~~<<:;~ ~
26'7822
~10 TI lG STATE AND CUUN7'Y 't'AX ASSI.:SSOR, ~
St.Lucie '
COUN7'Y, f~LOltll)A:
"Il~is is niy dcclaration of Domicilc and Citizcnship in tltc Statc of Florida that 1 am filing this day in :
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accordance, and in conformity with Scction 222.17, rlorida Statutcs.
1 was formcrly a lc al residcnt of , and 1 '
t'~-'-'-'~ ~ (Ci1y) (Stste) °
r~ sidcd at . However, [ have chansed my domicile to =
(Streel snd Number)
and am anc~ have been a bona fide resident oC the State of Fiorida since day o,~ ;
(Q now ct.G :
,
, , 19_.~~, and 1 /residc at -
. (Str t aod TFumber)
~fL~,f~ , St. Lucie County, Florida,
(citr) .
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State
of Florida. . '
(Insett here any perline~t facts, such u sale of praperty o? business, or relinquithment o[ employmcnt st formet
domicile. removal of fsmily to new domicile. purchue ot home, nte.) ,
~
Entering children in school: .
- iZS"~82iZ •
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- FIlEO AND RECOROED
SL lUC1E GOUNTY flA. ;
• tiOCE~ PGiTRAS - ~
. . ~ ~ ciE~K cu~GU~Y COURT ;
- RFr,(?R^ Yt~'r~ED~~~
. - NoY 6 I~ ve PM'73 I
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; I FURTHER CERTIFY that I will register at my local address when the registration books reopen, and
~ comply with all other requirements of a legal resident of this State. ~
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~ I FURTHER CERTIFY that i have no intention to return to my former domicile, and I intend to remain in
~ S~ Lucie `
E ' _ / ~--C.-C~- - - ' . County,
r (citr) ~ ~
4 Floryda, pcrmanen~ly. , - ;
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~ '•~j c~v\'' • 1.' , i _~s (isame)
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; _ ' . _ ~ _ ° . mc ~,~.~C, ded1:
~ ~ - . . _ : o~~ ~ 7 ~
{ ~ ~ ~ Q - • ~ ' (Aadreu) t
s - . ' I~V ~ ~ ` ~ rA. :
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"''•:.~e
' Swo~n ~o,and`~u Gs~riaed befo~e me this day of
~~°~"-1..~-? A.D.19 73 , ~E
~ ROGER POITRAS, CLERK CIRCUIT COURT ~
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~ .~~-,~-~arG~-..~,~,,_~o., ~ i~
~ - . . ~ ~-n ~ t~/ ~~.er~C- ~ tx
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~ (To 6t e=ecuted in Juplicate anJ uri~;inrl (~IeJ aith ('Irrk Circuit Courl, and duplM~te wilh Taz As~eswr)
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