HomeMy WebLinkAbout2111 '
C~ecl~ra~ian ofi Qor~i~~le ~na Ci~i~~~~I
~ t~ f! It: STA'I'l: AI~l1) ('UUN7'Y TAX ASSl~SSOR,
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~L-.Lucie `
_-_COUN7'1', i~LOKIUA:
"fliis is nty dcclaration of Domicilc ~nd Citir.cnship in thc Stat~ c~f rlorida lhat 1 am tiling Uiis day in -
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1 was formcrly a Icgal residc~zt of ~ ' , ` ~ and 1
~r) (s~a~
r~•,i~i~ d at _ ~`~S' `l ~.r•~~'~~ C~~ . Nowcver, I havc diangcd my domicilc to
(Street and Numbe~)
::n~l am and have bcen a bona fide resident of the Statc of l~lorida since l~ 3" 7-3 day of'
now p~ ~
- , 19_~_, and 1 /residc at ~ s ~ S- ~~=~~:~L~~ ~W < . ;
n ~ . (Strtet and Number) ;
~ St Lucie
~c;~y~ . County, Florida,.
:sn~t ti~is statement is ta be taken as my declaration of citizenship, actual legal residence and domicile in the State
c~f ?~ic.~rida. - ~
(Inscrl here any perlinent facts, such as sale ot ptoperty or business, or relinquishment of employment at tormer '
domicile, rrmo~al ot family to new domicile, purchase ot home, etc.)
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Entering children in school: Homestead Exemption ~ s1
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FIIED AtiC ~cCOr~0E0
. ST. LUCiE G~(~MTT F~A. • E' =
Rv^CE~ =i~1?RICS ~ '
CLEF'!; C~ :~.UtT COURT f
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Noy 8 3 2+~ PH '73 '
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I FURTHER CERTIFY ihat I will register at my tocal address when the registration books reopen, and ~
co?nply with all other rcqu~rements of a legal res~dent of ihis State. ~
I FURTHER CERTIFY that I have no intention to return to my former domicile, and I intend to remain in
' - ~ S* . Lucie i
- - ~ --..._„~r---- , County, ~ :
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• j~•.r~`~r loc~. = J'' , .~Lc:~-,.~i ~ z s
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te~..,~~-~~~~' ~ / S~"V ~~~C'~C'~~'"`"^'C.~ ~ ' I•
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~ ~ . ~AddltiS~ '
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S~,•or o~a~jc~es
b$cribed before me this _ O day of r~
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Nv!/P rn b P.Q _ 73
- y A.~. ~ 7 ! 2
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ROGER POITRAS, CLERK CIRCUIT COURT ~
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(To be etecuteJ in Juplicate and uri~, rl (drd wilh l'l.rk Circuil Cnurl. anJ Juplicrte wilh T~z Aueswr) ~
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